The underlying basis for Mg/Ca paleothermometry is that the amount of magnesium in calcite precipitated from seawater is dependent on temperature. Here we review the state of the art of the Mg/Ca seawater paleotemperature proxy, summarized by the following: 1) Calcite, whether formed abiotically or biologically as foraminifera and ostracode shells, incorporates variable amounts of magnesium into the crystal structure. 2) Uptake of Mg varies positively with temperature. 3) The relationship between temperature and the amount of Mg in calcite has been quantified by experiments on synthetic calcite growth and by culture, core top, and sediment trap experiments using living organisms. 4) The most careful calibrations of the Mg/Ca paleothermometer have been done for planktic foraminifera, then benthic foraminifera; there are species-specific variations in the amount of Mg incorporated into foraminifera shells. 5) The Mg/Ca ratio of calcite from planktic foraminifera in deep-sea cores has been widely used to interpret sea surface temperatures. 6) Measurement of both Mg/Ca and δ18O in planktic foraminifera have been used to calculate δ18O in seawater, and after correction for global ice volume, salinity could be inferred. 7) Mg/Ca from benthic foraminifera have been used to reconstruct deep-sea temperatures and cooling of ~12° over the last 50 million years. 8) One problem with the Mg/Ca seawater temperature proxy is partial dissolution of foraminifer shells, which lowers the Mg/Ca, and leads to an underestimation of ocean temperature. Benthic foraminifers appear to be more resistant to partial dissolution. 9) Past changes in the Mg/Ca ratio of seawater are an important factor in determining the amount of Mg in fossil skeletal calcite, and thus add another variable to the Mg/Ca temperature proxy. All Mg/Ca paleotemperature studies on fossil calcite older than Pleistocene should take into account the Mg/Ca of the seawater from which it precipitated.