Lipohypertrophy has been a recognized complication of insulin therapy for many years, yet research shows that its prevalence in insulin-injecting patients with diabetes remains high. The problem for the patient is that the injection of insulin into a site of lipohypertrophy, although painless, may lead to erratic absorption of the insulin, with the potential for poor glycaemic control and unpredictable hypoglycaemia. Despite the important implications of this for diabetes control in insulin-injecting patients, there is a dearth of information and completed research into the condition. This article raises awareness of lipohypertrophy by reviewing the available literature on the prevention, identification and management of the condition from a nursing perspective. Recommendations for medical and nursing practice in diabetes care to improve prevention and management of lipohypertrophy are made.