Testosterone levels have become a much more available and frequent screening test in clinical practice. There is greater awareness of testosterone deficiency symptoms both among the medical community and among the patients themselves. Several studies have described the effects of testosterone on carbohydrate and lipid metabolism and the disturbances that occur in patients with hypogonadism. However, whether testosterone replacement reverts such alterations is less clear. In this article, we review the effects of testosterone replacement therapy on glucose and lipid metabolism. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.