Background One of the chronic symptoms of non-freezing cold injury (NFCI) is cold sensitivity. This study examined the effects of prior exercise on the response to a cold sensitivity test (CST) in NFCI patients with the aim of improving diagnostic accuracy. Methods Twenty three participants, previously diagnosed with NFCI by a Cold Injuries Clinic, undertook two CSTs. Participants either rested (air temperature 31[degree sign]C) for approximately 80 min (prior rest condition (REST)) or rested for 30 min before exercising gently for 12 min (prior exercise condition (EX)). Following REST and EX, the participants placed their injured foot, covered in a plastic bag, into 15[degree sign]C water for 2 min; this was followed by spontaneous rewarming in 31[degree sign]C air for 10 min. Results The great toe skin temperature (Tsk) before immersion averaged 32.5 (3.4)[degree sign]C in both conditions. Following immersion, the rate of rewarming of the great toe Tsk was faster in EX compared to REST and was higher 5 min (31.7 (3.4)[degree sign]C vs. 29.8 (3.4)[degree sign]C) and 10 min (33.8 (4.0)[degree sign]C vs. 32.0 (4.0)[degree sign]C) post-immersion. Over the first 5 min of rewarming, changes in the great toe Tsk correlated with the changes in skin blood flow (SkBF) in EX but not the REST condition. No relationship was observed between Tsk in either CST and the severity of NFCI as independently clinically assessed. Conclusions Exercise prior to the CST increased the rate of the toe Tsk rewarming, and this correlated with the changes in SkBF. However, the CST cannot be used in isolation in the diagnosis of NFCI, although the EX CST may prove useful in assessing the severity of post-injury cold sensitivity for prognostic and medico-legal purposes.