Apart from few studies, the majority of the research conducted on the effects of heat stress on energy metabolism during exercise has only been done so in the past two decades. Whilst increasing exercise duration under conditions of heat stress favours the oxidation of carbohydrate (CHO) and appears to increase the rate of muscle glycogenolysis, total CHO oxidation is often less and levels of muscle glycogen remain much higher at the point of fatigue when compared with the same exercise without heat stress. Furthermore, supplementing CHO during exercise in the heat appears to exert an ergogenic effect that is not related to 'peripheral' but rather 'central' factors. However, there may be a role for the excess ammonia (NH3) produced in the exercising muscle during heat stress, as cerebral uptake and subsequent metabolism of NH3 may have detrimental effects on cerebral function. Recent exciting results point toward an increased cerebral CHO uptake relative to that of O2, termed the cerebral metabolic ratio (CMR) during exercise with heat stress, although a causative link between this and reduced exercise performance has yet to be identified. Therefore, it appears that despite a shift towards greater CHO utilisation in both skeletal muscular and cerebral metabolism, these responses have ultimately not proved limiting to exercise with heat stress.