In a single subject design, acupuncture effects on peripheral skin temperature were studied in six children with cold feet associated with cerebral palsy, progressive encephalopathy or Smith-Lemli-Opitz syndrome. Skin temperature was measured at fixed points on the forehead, suprasternal fossa, hand dorsum and palm, foot dorsum and sole from a distance of 3 cm with a Raytek Raynger ST2L. Acupuncture needles were inserted in arms or legs with or without electrical stimulation. Three children displayed a brief rise in temperature in the hands and one in the feet. A tendency towards a cumulative effect in improved skin temperature occurred in two of three children receiving additional sessions. One child did not respond to acupuncture. It is possible that acupuncture may increase skin temperature in some children with cold extremities of neurological origin. Studies in larger groups are needed.