OBJECTIVE: To compare the skin surface temperature during the application of 4 cryotherapy modalities. DESIGN: A repeated-measures design. SETTING: Laboratory experiment. PARTICIPANTS: Convenience sample of 50 women (age range, 20-23 y; mean, 20.6+/-0.8 y). INTERVENTIONS: Each of the 4 cryotherapy modalities (ice pack, gel pack, frozen peas, mixture of water and alcohol) was applied randomly to the skin overlying the right quadriceps femoris muscle. MAIN OUTCOME MEASURE: Skin surface temperature recorded every minute for 20 minutes. RESULTS Throughout 20 minutes of cryotherapy application, the ice pack and mixture of water and alcohol showed significantly lower skin surface temperatures than the gel pack or frozen peas (P < .001). The mean skin surface temperature at the 20th minute of application with the ice pack, gel pack, frozen peas, and mixture of water and alcohol was 10.2 degrees +/-3.5 degrees , 13.9 degrees +/-4.1 degrees , 14.4 degrees +/-3.0 degrees , and 10.0 degrees +/-4.5 degrees C, respectively. CONCLUSIONS: The ice pack and mixture of water and alcohol were significantly more efficient in reducing skin surface temperature than the gel pack and frozen peas.