Failures (or upsets) of complementary metal-oxide-semiconductor (CMOS) devices, due to direct ionization from protons, were first predicted in 1982 and subsequently realized in 2007 for low-energy (1 MeV) protons (LEPs). For terrestrial applications, secondary LEPs, generated during collision events, may cause upsets, especially in cells far away from the initial strike location than their heavier spallation-fragment cousins. However, direct ionization may be more important in space and high-altitude environments due to the large flux of primary high-energy protons impinging on nearby spacecraft (and local device) shielding. In this article, a brief review of the relevant literature will be followed by a discussion of the sensitivity to direct ionization of typical CMOS devices. It will be shown that a significant number of LEPs are generated by cosmic radiation spallation events, suggesting that track structures and exact device hit locations need to be understood and effectively modeled, especially for modern devices. Also, the rate of multiple cell upsets, and hence multiple bit upsets, in these environments will be explored, with possible mitigation techniques discussed. The published work on muons and delta electrons, in addition to LEPs, will be reviewed as potential single-event upset (SEU) sources with the future scaling of CMOS devices.