The advent of commercially available real-time (rt) continuous glucose monitoring (CGM) is revolutionizing diabetes care. This technology, which allows patients to view an approximation of their blood glucose (BG) levels every 5 min, permits fine-tuning of a patient's glycemic control that is not possible with self-monitoring of BG. While at first glance this technology seems too good to be true, it is still early in its development, and thus some practical aspects of its use must be considered before recommending rt-CGM to every patient with diabetes. Every clinician who prescribes these devices needs to understand the balance between the potential for improving diabetes control, the safety features, the economic implications, and the patient factors, all of which impact the decision to prescribe rt-CGM for an individual patient. In this review, we will discuss the practical benefits and challenges of rt-CGM use, in order to better educate care providers as to which of their patients might actually benefit from this technology.