The extreme physical endurance demands and varied environmental settings of marathon footraces have provided a unique opportunity to study the limits of human thermoregulation for more than a century. High post-race rectal temperatures (Tre) are commonly and consistently documented in marathon runners, yet a clear divergence of thought surrounds the cause for this observation. A close examination of the literature reveals that this phenomenon is commonly attributed to either biological (dehydration, metabolic rate, gender) or environmental factors. Marathon climatic conditions vary as much as their course topography and can change considerably from year to year and even from start to finish in the same race. The fact that climate can significantly limit temperature regulation and performance is evident from the direct relationship between heat casualties and Wet Bulb Globe Temperature (WBGT), as well as the inverse relationship between record setting race performances and ambient temperatures. However, the usual range of compensable racing environments actually appears to play more of an indirect role in predicting Tre by acting to modulate heat loss and fluid balance. The importance of fluid balance in thermoregulation is well established. Dehydration-mediated perturbations in blood volume and blood flow can compromise exercise heat loss and increase thermal strain. Although progressive dehydration reduces heat dissipation and increases Tre during exercise, the loss of plasma volume contributing to this effect is not always observed for prolonged running and may therefore complicate the predictive influence of dehydration on Tre for marathon running. Metabolic heat production consequent to muscle contraction creates an internal heat load proportional to exercise intensity. The correlation between running speed and Tre, especially over the final stages of a marathon event, is often significant but fails to reliably explain more than a fraction of the variability in post-marathon Tre. Additionally, the submaximal exercise intensities observed throughout 42 km races suggest the need for other synergistic factors or circumstances in explaining this occurrence. There is a paucity of research on women marathon runners. Some biological determinants of exercise thermoregulation, including body mass, surface area-to-mass ratio, sweat rate, and menstrual cycle phase are gender-discrete variables with the potential to alter the exercise-thermoregulatory response to different environments, fluid intake, and exercise metabolism. However, these gender differences appear to be more quantitative than qualitative for most marathon road racing environments.