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To study ice therapy guidance in sports medicine textbooks.A systematic search of a convenience sample of textbooks.45 general sports medicine texts were included in the study.The indices and chapter headings of each text were searched using key words “ice,” “cryotherapy,” “soft tissue injury,” “muscle,” and “bruise.”In 17 of the textbooks, there was no guidance on the duration, frequency, or length of ice treatment or on the use of barriers between ice and the skin. Advice on treatment duration was given in 28 texts but recommendations differed depending on the particular ice therapy, injury location, or severity. There was considerable variation in the recommended duration and frequency of advised treatments.There was little guidance in the standard textbooks on ice application, and the advice varied greatly. There is a need for evidence-based sport and exercise medicine with a consensus on the appropriate use of ice in acute soft tissue injury.