The mining industry is among the top ten industries nationwide with high occupational injury and fatality rates, and mine rescue response may be considered one of the most hazardous activities in mining operations. In the aftermath of an underground mine fire, explosion or water inundation, specially equipped and trained teams have been sent underground to fight fires, rescue entrapped miners, test atmospheric conditions, investigate the causes of the disaster, or recover the dead. Special personal protective ensembles are used by the team members to improve the protection of rescuers against the hazards of mine rescue and recovery. Personal protective ensembles used by mine rescue teams consist of helmet, cap lamp, hood, gloves, protective clothing, boots, kneepads, facemask, breathing apparatus, belt, and suspenders. While improved technology such as wireless warning and communication systems, lifeline pulleys, and lighted vests have been developed for mine rescuers over the last 100 years, recent research in this area of personal protective ensembles has been minimal due to the trending of reduced exposure of rescue workers. In recent years, the exposure of mine rescue teams to hazardous situations has been changing. However, it is vital that members of the teams have the capability and proper protection to immediately respond to a wide range of hazardous situations. Currently, there are no minimum requirements, best practice documents, or nationally recognized consensus standards for protective clothing used by mine rescue teams in the United States (U.S.). The following review provides a summary of potential issues that can be addressed by rescue teams and industry to improve potential exposures to rescue team members should a disaster situation occur. However, the continued trending in the mining industry toward non-exposure to potential hazards for rescue workers should continue to be the primary goal. To assist in continuing this trend, the mining industry and regulatory agencies have been more restrictive by requiring additional post disaster information regarding atmospheric conditions and other hazards before exposing rescue workers and others in the aftermath of a mine disaster. In light of some of the more recent mine rescuer fatalities such as the Crandall Canyon Mine and Jim Walters Resources in the past years, the direction of reducing exposure is preferred. This review provides a historical perspective on ensembles used during mine rescue operations and summarizes environmental hazards, critical elements of mine rescue ensembles, and key problems with these elements. This study also identifies domains for improved mine rescue ensembles. Furthermore, field observations from several coal mine rescue teams were added to provide the information on the currently used mine rescue ensembles in the U.S.