Context: Although body cooling has both performance and safety benefits, knowledge on optimizing cooling during specific sport competition is limited. Objectives: To identify when, during sport competition, it is optimal for body cooling and to identify optimal body-cooling modalities to enhance safety and maximize sport performance. Evidence Acquisition: A comprehensive literature search was conducted to identify articles with specific context regarding body cooling, sport performance, and cooling modalities used during sport competition. A search of scientific peer-reviewed literature examining the effects of body cooling on exercise performance was done to examine the influence of body cooling on exercise performance. Subsequently, a literature search was done to identify effective cooling modalities that have been shown to improve exercise performance. Evidence Synthesis: The cooling modalities that are most effective in cooling the body during sport competition depend on the sport, timing of cooling, and feasibility based on the constraints of the sports rules and regulations. Factoring in the length of breaks (halftime substitutions, etc), the equipment worn during competition, and the cooling modalities that offer the greatest potential to cool must be considered in each individual sport. Conclusions: Scientific evidence supports using body cooling as a method of improving performance during sport competition. Developing a strategy to use cooling modalities that are scientifically evidence-based to improve performance while maximizing athlete's safety warrants further investigation. Keywords: cooling modality, body temperature, cooling rate, review Athletes competing in competitive sports strive to maximize athletic performance (increased strength, faster completion times in timed aerobic and anaerobic events, increased cognition in sport-specific skills, and increased exercise capacity in competitions of set time duration) to perform at the highest level. During competition, especially in the heat, it is not uncommon for athletes to reach body temperatures in the range of 39°C to 40°C, which could have negative effects on performance and increase the risk of heat illness. 1,2 To combat these potentially deleterious effects, athletes often use various body-cooling techniques to lower or mitigate the rise in body temperature during competition.There are currently 2 hypotheses that account for the negative physiological and performance effects that increasing body temperature has on athletic performance: the critical-temperature hypothesis and the anticipatory hypothesis. The critical-temperature hypothesis centers on the concept that the body will decrease intensity when body temperature reaches a "critical threshold" of 40°C to prevent exertional heat stroke (EHS) from occurring. 1,3,4 The anticipatory model states that the brain will anticipate the increase in body temperature and thus alter intensity during exercise to prevent body temperature from reaching unsafe levels. [5][6][7] In both theories, exe...