The performance of both physical and mental tasks can be adversely affected by heat and by dehydration. There are well recognised effects of heat and hydration status on the cardiovascular and thermoregulatory systems that can account for the decreased performance and increased sensation of effort that are experienced in the heat. Provision of fluids of appropriate composition in appropriate amounts can prevent dehydration and can greatly reduce the adverse effects of heat stress. There is growing evidence that the effects of high ambient temperature and dehydration on exercise performance may be mediated by effects on the central nervous system. This seems to involve serotonergic and dopaminergic functions. Recent evidence suggests that the integrity of the blood brain barrier may be compromised by combined heat stress and dehydration, and this may play a role in limiting performance in the heat.