We examined the interactive effects of mild hypothermia and hypoxia on finger vasoreactivity to local cold stress. Eight male lowlanders performed, in a counterbalanced order, a normoxic and a hypoxic (partial pressure of oxygen: similar to 12 kPa) hand cold provocation (consisting of a 30-min immersion in 8 degrees C water), while immersed to the chest either in 21 degrees C [cold trials; 0.5 degrees C fall in rectal temperature (T-rec) from individual preimmersion values], or in 35.5 degrees C water, or while exposed to 27 degrees C air. The duration of the trials was kept constant in each breathing condition. Physiological (T-rec, skin temperature, cutaneous vascular conductance, oxygen uptake) and perceptual (thermal sensation and comfort, local pain, affective valence) reactions were monitored continually. Hypoxia accelerated the drop in T-rec by similar to 14 min (P = 0.06, d = 0.67). In the air-exposure trials, hypoxia did not alter finger perfusion during the local cooling. whereas it impaired the finger rewarming response following the cooling (P < 0.01). During the 35.5 degrees C immersion, the finger vasomotor tone was enhanced, especially in hypoxia (P = 0.01). Mild hypothermia aggravated finger vasoconstriction instigated by local cooling (P < 0.01), but the response did not differ between the two breathing conditions (P > 0.05). Hypoxia tended to attenuate the sensation of coldness (P = 0.10, r = 0.40) and thermal discomfort (P = 0.09, r = 0.46) in the immersed hand. Both in normoxia and hypoxia, the whole body thermal state dictates the cutaneous vasomotor reactivity to localized cold stimulus.