Bitter gourd (Momordica charantia) is a vegetable with pantropical distribution. It contains substances with antidiabetic properties such as charantin, vicine, and polypeptide-p, as well as other unspecific bioactive components such as antioxidants. Metabolic and hypoglycemic effects of bitter gourd extracts have been demonstrated in cell culture, animal, and human studies. The mechanism of action, whether it is via regulation of insulin release or altered glucose metabolism and its insulin-like effect, is still under debate. Adverse effects are also known. Nevertheless, bitter gourd has the potential to become a component of the diet or a dietary supplement for diabetic and prediabetic patients. Well-designed interdisciplinary research by nutritionists, medical doctors, and agronomists is needed before a dietary recommendation can be given and a product brought to the market.