Summary Aside from injuries caused by direct contact with hot or cold substances or objects, exposure to extreme temperatures in the workplace entails physical hazards for workers. The performance and alertness of poorly acclimated workers may be impaired, making them more vulnerable to accidents and injuries. Because existing standards are incompatible with some work environments and many types of protective equipment lack thermoregulation capacity, heat stress remains one of the most prevalent risks in many labour sectors. Many of these problems can be overcome through smart textile technologies that enable smart thermoregulation of personal protective equipment. This study was thus conducted to better document the body of current knowledge about these technologies by reviewing the state of the art of commercially available systems and identifying the advances made in previous research work. First, a technical and scientific data base was created using (1) a review of previous studies on the design of integrated thermoregulation systems using smart textiles and the development of flexible electronics, and (2) a collection of technical data on existing commercial systems, through information available on manufacturers’ websites and the technical data sheets of marketed products. This data base was then analyzed according to four categories: (i) real-time heat stress detection, (ii) temperature sensor, (iii) heating actuator and (iv) cooling actuator. The analysis of the compiled data led to discussion about the potential benefits and limitations of current technological advances, and the feasibility of adapting them for use in an occupational health and safety context. To better elucidate the gap that must be bridged to facilitate the adaptation and integration of these systems into personal protective equipment, their technological shortcomings were examined to highlight the areas in which current systems could be optimized and thus better guide the development strategies to be implemented. Some perspectives for future work are also presented using qualitative analysis.