Introduction: Cold injuries in Western Australia are becoming more common secondary to recreational activities such as sniffing nitrous oxide, the use of “frosties” (cold aerosol burns), and hiking in extreme climates. Hyperbaric oxygen therapy (‘HBOT’) is indicated for chronic wounds. Little is known about the use of HBOT in burns especially cold injuries. Purpose: To examine the role of hyperbaric oxygen therapy (‘HBOT’) on healing in cold injury burns. Methods: This study describes a retrospective case review of an 18-year-old female who sustained a cold injury from a nitrous oxide canister. Demographics, interventions, and treatment details are described. Illustrative photos provided. Results: This patient sustained a cold injury to her left dorsal second, third, and fourth digits for a total of 0.2% TBSA deep partial thickness burn. At the time of injury, she underwent first aid with 20 minutes of warm water followed by 20 minutes of cold water at the emergency department. She presented approximately 16 hours post-injury to the state-wide burn unit walk-in clinic. At the time of presentation, the injury looked so severe that she was counselled by a senior burns consultant that she may require an amputation of the third digit. She was admitted for two days for pain control, dressings, and elevation. HBOT commenced on post-burn day 3 and she underwent a total of 4 dives. Her fingers were salvaged and underwent split-thickness skin grafting to three digits 23 days later. She was fully healed at post-operative day 7. Conclusion: HBOT may be a useful adjunct in cold injuries even with a limited number of dives to optimise outcomes.