The cold chain is responsible for the preservation and transportation of perishable foods in the proper temperature range to slow biological decay processes and deliver safe and high-quality foods to consumers. Studies show that the efficiency of the cold chain is often less than ideal, as temperature abuses above or below the optimal productspecific temperature range occur frequently, a situation that significantly increases food waste and endangers food safety. In this work, field studies on time-temperature conditions at each critical stage of the cold chain are reviewed to assess the current state of commercial cold chains. Precooling, ground operations during transportation, storage during display at retail and in domestic refrigerators, and commercial handling practices are identified and discussed as the major weaknesses in the modern cold chain. The improvement in efficiency achieved through the measurement, analysis, and management of time-temperature conditions is reviewed, along with the accompanying technical and practical challenges delaying the implementation of such methods. A combination of prospective experimental and modeling research on precooling uniformity, responsive food inventory management systems, and cold chains in developing countries is proposed for the improvement of the cold chain at the global scale.