Cold-weather emergencies are among the most challenging situations for providers, and hypothermia is not confined to the backcountry. Patients can be found in urban alleyways, vehicle crashes, flood disasters, mountain trails, or even post-rescue settings where cold exposure becomes life-threatening. This session focuses on recognition, pathophysiology, and management of hypothermia across these diverse environments. Through case-based discussion and evidence-driven strategies, participants will learn to assess severity, initiate appropriate rewarming, and prevent further heat loss when resources are limited. Attendees will leave with a practical framework to improve outcomes for patients who are cold, vulnerable, and critically ill — no matter the setting.