The medicines refrigerator is a common piece of equipment found in clinical areas. It is used to ensure specific medicines are safely stored within a narrow temperature range in line with manufacturers’ instructions; this is usually between +2˚C and +8˚C, and ideally +5˚C. Drugs stored in the medicines refrigerator include: vaccines; insulin; chemotherapy drugs; topical preparations, such as some types of eye drops; and other treatments such as glucagon, which is used to manage severe hypoglycaemia. This article reviews the function of the medicines refrigerator and the checks required by healthcare practitioners to ensure that medicines remain safely stored and their effectiveness is maintained. It also outlines the medicines refrigeration procedure known as the ‘cold chain’, which includes the use of cold boxes or vaccine carriers to maintain the required temperature of medicines during transport from the manufacturer to user, or between healthcare departments.