Rotation-powered "recycled" millisecond pulsars are a variety of rapidly-spinning neutron stars that typically show thermal X-ray radiation due to the heated surface of their magnetic polar caps. Detailed numerical modeling of the rotation-induced thermal X-ray pulsations observed from recycled millisecond pulsars, including all relevant relativistic and stellar atmospheric effects, has been identified as a promising approach towards an astrophysical determination of the true neutron star mass-radius relation, and by extension the state of cold matter at densities exceeding those of atomic nuclei. Herein, I review the basic model and methodology commonly used to extract information regarding neutron star structure from the pulsed X-ray radiation observed from millisecond pulsars. I also summarize the results of past X-ray observations of these objects and the prospects for precision neutron star mass-radius measurements with the upcoming Neutron Star Interior Composition Explorer (NICER) X-ray timing mission.