Elevation training masks have grown in usage as they have been popularized by professional athletes or by popular movies. The masks have been marketed to suggest that they can simulate exercise in high altitude elevations or provide the benefits of hypoxic training. There is limited research on the effectiveness of these devices. These devices can restrict oxygen to the user, can increase rebreathing expired CO2 trapped in the users’ mask and even limit hydration during workouts. These are very real concerns for users and facility operators to consider. From a risk vs reward review there seems to be little evidence that the benefits outweigh the concerns and support the use of these devices among the mainstream population. Organizations are encouraged to review the use of these devices and take appropriate action to restrict or ban their use until strong evidence is available to support their use in the public/private fitness environment.