Listeria monocytogenes is a foodborne pathogen that can cause serious invasive human illness in susceptible patients, notably immunocompromised, pregnant women, and adults >65 years old. Most human listeriosis cases appear to be caused by consumption of refrigerated ready-to-eat foods that are contaminated with high levels of L. monocytogenes. While initial L. monocytogenes levels in contaminated foods are usually low, the ability of L. monocytogenes to survive and multiply at low temperatures allows it to reach levels high enough to cause human disease, particularly if contaminated foods that allow for L. monocytogenes growth are stored for prolonged times under refrigeration. In this review, relevant knowledge on the physiology and genetics of L. monocytogenes' ability to adapt to and multiply at low temperature will be summarized and discussed, including selected relevant findings on the physiology and genetics of cold adaptation in other Gram-positive bacteria. Further improvement in our understanding of the physiology and genetics of L. monocytogenes cold growth will hopefully enhance our ability to design successful intervention strategies for this foodborne pathogen.