Reduced environmental temperatures that above freezing may cause a neuropathy without concomitant injury to other tissues. A 22-year-old man had developed peripheral neuropathy at both upper extremities following accidental exposure to cold weather. Electrophysiologic study revealed severe axonopathy. The literature about cold-induced neuropathy is reviewed. The three electrophysiologic studies reported previously in cold-induced neuropathy patients are discussed. Despite the plenty of reports on the various syndormes following cold injury in humans and experimental animals, controversy still exists concerning the morphology and pathophysiology of cold-induced nerve injury. This uncertainty may in part be due to the paucity of electrodiagnostic and pathologic data in reported patients, the variations in species used, or nerves examined in experimental studies.