Purpose: The objective of this review was to analyze the physiological impact of fire suppression on the human body. Design: The literature review included studies focused on workload requirements for common firefighting tasks, effect of health status on the firefighting profession, and attempts to establish a minimum physiological workload capacity for successful performance of firefighting. Findings: The existing literature provides evidence of the high degree of physiological stress that firefighters are under during fire suppression tasks and the great degree of maximal physical capacity that firefighting often requires. Firefighters often operate close to maximal aerobic capacity while performing tasks common to the profession. This is especially true due to the added physiological stress placed on the human body while wearing personal protective equipment during firefighting. Conclusions: Future investigations are necessary to further explore markers of physiological stress during firefighting and the impact that it may have on the ability to withstand the development of disease as well as fire suppression safety. Using completion time of fire suppression tasks as a criterion of success may be an important consideration in addition to the physiological requirements of the occupation when assessing the appropriateness of an individual to be a firefighter. An important future consideration is the effect that fire suppression activities may have on reaction time in critical situations in which life-and-death decisions must be made.