Contents: Reduced reproductive performance of lactating cows during the summer is associated with decreased thermoregulatory competence due to intensive genetic selection for high milk production. This review examines the immediate and delayed effects of heat stress on follicular function and describes some potential strategies for their alleviation. It focuses on how heat stress affects the follicle and its enclosed oocyte, suggesting that perturbations in the follicular microenvironment, to which the oocytes are exposed for long periods of development, reduce their developmental competence. Among the potential alterations are reduction in gonadotropin secretion, alteration in follicular growth, attenuation of dominance, and disruption of steroidogenesis. Evaporative cooling methods are the most common strategy used to alleviate the effect of heat stress; however, there is a compelling need to find additional ways to improve fertility during the summer and autumn. Hormonal treatment to enhance removal of the impaired follicles by synchronization of follicular waves with GnRH and PGF2α is suggested. An alternative method is stimulation of follicular growth by a brief treatment with bST or FSH. Other strategies, such as timed AI and embryo transfer, have been recently used, making the optimization of embryo cryopreservation procedures highly relevant. Protection of the ovarian pool of oocytes from thermal stress via nutritional manipulations or administration of antioxidants or other survival factors should also be considered. A better understanding of the underlying mechanisms by which heat stress impairs fertility may lead to the development of additional approaches to alleviate these effects.