Chromium picolinate is a widely available nutritional supplement marketed for a plethora of afflictions. There is some evidence, including results from human studies, that it has a role in glucose homeostasis. We report the case of a 28-year-old woman with an 18-year history of type 1 diabetes mellitus whose glycosylated hemoglobin (Hb A1c) declined from 11.3% to 7.9% 3 months after initiation of chromium picolinate, 200 micrograms 3 times daily. Chromium picolinate continues to fall squarely within the scope of "alternative medicine," with both unproven benefits and unknown risks. It deserves closer scrutiny with additional prospective, randomized, double-blind, placebo-controlled trials to evaluate its efficacy in improving outcomes in patients with diabetes. A brief review of the literature was done to assist physicians who are being called upon to counsel and treat patients who are engaging in alternative therapies.