Nowdays, occupational and recreational activities in cold environments are common. Exposure to cold induces thermoregulatory responses like changes of behaviour and physiological adjustments to maintain thermal balance either by increasing metabolic heat production by shivering and/or by decreasing heat losses consecutive to peripheral cutaneous vasoconstriction. Those physiological responses present a great variability among individuals and depend mainly on biometrical characteristics, age, and general cold adaptation. During severe cold exposure, medical disorders may occur such as accidental hypothermia and/or freezing or non-freezing cold injuries. General cold adaptations have been qualitatively classified by Hammel and quantitatively by Savourey. This last classification takes into account the quantitative changes of the main cold reactions: higher or lower metabolic heat production, higher or lesser heat losses and finally the level of the core temperature observed at the end of a standardized exposure to cold. General cold adaptations observed previously in natives could also be developed in laboratory conditions by continuous or intermittent cold exposures. Beside general cold adaptation, local cold adaptation exists and is characterized by a lesser decrease of skin temperature, a more pronounced cold induced vasodilation, less pain and a higher manual dexterity. Adaptations to cold may reduce the occurrence of accidents and improve human performance as surviving in the cold. The present review describes both general and local cold adaptations in humans and how they are of interest for cold workers.