Thermally induced loads in motor spindles can cause a number of undesired effects. As a result, the process capability of spindles, and thus, the productivity of a process can decrease. Future motor spindles will be exposed to higher mechanical and especially thermal loads due to trends aiming to increase power densities and maximum speeds. These trends are amplified by increasingly powerful drive concepts and developments in bearing technology. Therefore, researchers assume that it will not be possible to raise the performance potential of spindles due to insufficient cooling of its heat sources. A series of different cooling concepts have been researched and developed in recent decades. These developments have been made for different purposes. They also differ considerably in terms of their cooling principles and cooling performance. In this article, these cooling approaches and the motivations for their development are described. Firstly, the causes of heat development in motor spindles are described in a historical context. Subsequently, the effects of heat development on the manufacturing-relevant properties of motor spindles are revealed. Finally, current deficits in the area of spindle cooling and the need for the development and transfer into industrial practice of more efficient and cost-effective cooling concepts to overcome future challenges are discussed.