This project evaluated solid-phase extraction (SPE) combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS) to determine the trace amount of rosiglitazone in human urine. The analytical performance of four modes of LC-MS and tandem MS operation (atmospheric pressure chemical ionization (APCI), electrospray ionization (ESI), positive and negative ionization) was compared for two mass spectrometers, a triple-quadrupole and a quadrupole ion trap instrument. Rosiglitazone was extracted from urine using a SPE cartridge of 50mg C8 sorbent and acetonitrile used as the eluting solvent. Samples were then separated on a RP18 column interfaced with a tandem mass spectrometer. The recovery of rosiglitazone was greater than 91.2%. The urine assay combining SPE and LC-APCI-MS/MS of triple-quadrupole was proved a very selective and sensitive method for determination of trace rosiglitazone. The assay was linear over a wide range, with a lower limit of quantification of 0.1 ng/mL using 1 mL of urine. The intra- and inter-day precisions were <9.8% and <7.9%, respectively, and the accuracies were in the range 91.0-103.6%. The rosiglitazone concentration profile in human urine was also determined. The results of this study reveal the adequacy of SPE-LC-APCI-MS/MS method for analyzing rosiglitazone from diabetic patients' urines. The concentrations of rosiglitazone were detected to range from 760 to 164 pg/mL.