Indian Armed Forces are constrained to deploy a large number of troops in the western Himalayas in the interest of national security and territorial integrity. The region represents extremely rugged, arid and cold climatic conditions. The altitude ranges from 8000 to 23000 feet with winter temperatures ranging from -35°C to - 55°C in some regions. Low environmental humidity, hypo-baric hypoxia and high solar ultra-violet radiation with its attendant problems further compound the hardships faced by the troops in these climatic conditions. The role of the Armed Forces medical personnel is extremely challenging, as they have to ensure maintenance of health and physical fitness of the troops to ensure optimal performance during peace and during operations. These considerations include nutrition, physical fitness programmes suitable for the terrain and climatic conditions, protection against cold and hypoxia induced health problems, clothing and shelter taking into consideration the ergonomic factors, human waste disposal and prompt medical attention and evacuation in case of illness. An overview of the effects of cold hypoxic environment on health and performance of Indian troops, measures employed by the Armed Forces to maintain health of troops including psychological factors and the incidence of various cold induced health problems during peace time compared to operational period over the last 10 years is presented in this paper.