Changes of microcirculatory perfusion in rats following cold injury of right hind leg under hypoxia were investigated. Male Wistar rats weighing 200 +/- 20 g were randomly divided into three groups: frostbite at normoxia (FN) group; frostbite during acute hypoxia (4 h at 6000 m simulated altitude, FAH) group and frostbite during hypoxia after acclimation (exposure to hypoxia at 6000 m, 4 h daily for 4 weeks, FHAC) group. The results showed that the microcirculatory perfusion of both hind legs decreased markedly in FN after cold injury. It suggests that the frostbite damage can affect microcirculatory perfusion of another leg besides the region of frostbite. The fall of microcirculatory perfusion before freezing in FAH group indicated that there was a compensatory blood redistribution during acute hypoxia. The changes of microcirculatory perfusion in FAH group post-freezing indicated that acute hypoxia can aggravate the frostbite damage. The microcirculatory perfusion of FHAC group pre-freezing was significantly lower than that of FN and FAH group, and after freezing the perfusion of frostbitten leg in FHAC group was significantly lower than that in FN group, suggesting that hypoxia acclimation may cause disturbance of microcirculation and worsen the frostbite damage at high altitude.