Abstract: A pressure variable thermal adaptive microclimate surface is provided. The microclimate surface may be a pad, pillow, mattress or the like. The microclimate surface is especially suitable for providing optimal heating and/or cooling of a person. The heating or cooling is provided through heating or cooling delivery system located in the sculpted polyurethane foam microclimate surface. The microclimate surface has a plurality of independently moving pillars which is optimal in reducing pressure ulcers on the skin of a person caused by the person spending extended periods of time on a typical surface, such as a hospital mattress. The heating or cooling delivery system may be provided through three possible configurations.