Adaptation to environmental stresses, such as temperature fluctuation, is essential for the survival of all living organisms. Cellular responses in both prokaryotes and eukaryotes to high temperature include the synthesis of a set of highly conserved proteins known as the heat shock proteins. In contrast to the heat shock response, adaptation to low temperatures has not been as extensively studied. However, a family of cold-inducible proteins is evident in prokaryotes. In addition, most organisms have developed adaptive mechanisms that alter both membrane fluidity and the protein translation machinery at low temperature. This review addresses the different adaptive mechanisms used by a variety of organisms with a focus on the molecular mechanisms of cold adaptation that have recently been identified during the cold shock response in Escherichia coli.