&NA;The use of POCT glucose meters has become routine in our health system. This study was organized to find the existing evidence supporting the optimal use of glucose meters in patient care. Medline OVID database was searched, and the 171 citations found were systematically reviewed and graded (A, B, C, or E) based on the ADA evidence grading system. Several conclusions were synthesized: 1) optimal meter performance requires a defined quality assurance program (C evidence); 2) quality assurance programs for glucose meters should emphasize operator training (C evidence); 3) the laboratory should be involved in the quality assurance of glucose meters whenever possible (C evidence); 4) there is a lack of consensus for meter performance criteria (accuracy and precision expectations) (E evidence); 5) the selection of meters should match the clinical application to user feature and analytical performance (C evidence); 6) meter performance is limited by a variety of environmental, physiologic, and operator factors that the clinician should understand to adequately interpret results (C evidence); 7) the analytical performance of the current generation of meters is inadequate for clinical use in diagnosis of diabetes or in the general screening of asymptomatic patients (E evidence); and 8) there is significant support for the role of glucose meters in management (hospital, outpatient, home self‐management) of patients already diagnosed with diabetes (C evidence). While this study was limited in scope, there is support for general use of glucose meters on diabetics and a need for quality assurance and improved international performance criteria. The power and limitations of the evidence‐based process are also discussed.