Purpose: To quantify, for an elite-level racewalker, altitude training, heat acclimation and acclimatization, physiological data, and race performance from January 2007 to August 2008. Methods: The participant performed 7 blocks of altitude training: 2 “live high:train high” blocks at 1380 m (total = 22 d) and 5 simulated “live high:train low” blocks at 3000 m/600 m (total = 98 d). Prior to the 2007 World Championships and the 2008 Olympic Games, 2 heat-acclimation blocks of ~6 weeks were performed (1 session/week), with ∼2 weeks of heat acclimatization completed immediately prior to each 20-km event. Results: During the observation period, physiological testing included maximal oxygen uptake (VO2max, mL·kg−1·min−1), walking speed (km·h−1) at 4 mmol·L−1 blood lactate concentration [La−], body mass (kg), and hemoglobin mass (g), and 12 × 20-km races and 2 × 50-km races were performed. The highest VO2max was 67.0 mL·kg−1·min−1 (August 2007), which improved 3.1% from the first measurement (64.9 mL·kg−1·min−1, June 2007). The highest percentage change in any physiological variable was 7.1%, for 4 mmol·L−1 [La−] walking speed, improving from 14.1 (June 2007) to 15.1 km·h−1 (August 2007). Personal-best times for 20 km improved from (hh:mm:ss) 1:21:36 to 1:19:41 (2.4%) and from 3:55:08 to 3:39:27 (7.1%) in the 50-km event. The participant won Olympic bronze and silver medals in the 20- and 50-km, respectively. Conclusions: Elite racewalkers who regularly perform altitude training may benefit from periodized heat acclimation and acclimatization prior to major international competitions in the heat.