Therapeutic hypothermia is used to reduce mortality and morbidity following cardiac arrest. It is increasingly being used to cover a variety of indications including primary out-of-hospital ventricular fibrillation (VF) and non-VF cardiac arrests, in-hospital cardiac arrests and cardiac arrests of secondary cause. We have studied indications, techniques, efficiency, outcomes and complications of post-cardiac arrest cooling processes used in routine clinical practice in intensive care units in the north west of England. Survival at hospital discharge post-VF arrest was 53% in this multicentre cohort and all survivors at discharge had good or fair neurological recovery. This study confirms that our cooling and rewarming practices are effective and similar to those described in current literature, and meet standards set by the International Liaison Committee for Resuscitation (ILCOR).