We believe available data support the thesis that HA can improve performance in cool conditions, and perhaps with less expense and fewer side-effects than hypoxia (Dempsey & Morgan, 2015), but its utility is unresolved and may be modest or absent in some settings and individuals. A few key issues are becoming clear, however. First, HA must be of sufficient stimulus and duration, with key evidence indicating longer is better. Second, individual variability in response to HA as an ergogenic aid needs to be considered. Third, key training aspects such as speed and intensity may need to be maintained, and ideally performed in a cooler environment to maximize gains and minimize fatigue (including the effects of matched absolute versus relative work rates on adaptations). Alternatively, passive heating should be considered (e.g. immediately after training). Fourth, there is no evidence that HA impairs cool weather performance, and thus HA is a useful strategy when the competitive environmental conditions are potentially hot or unknown. Fifth, much remains unknown about ideal timing for competition following HA and its decay. Lastly, an ergogenic effect of HA has yet to be studied in truly elite athletes.