The introduction of home blood glucose monitoring (BGM) 40 years ago revolutionized diabetes self-management, providing valuable glucose data that have helped many people with diabetes (PWD) improve their glycemic management. In the early 2000s, personal continuous glucose monitoring (CGM) systems also became available, raising questions regarding the future role of BGM. However, for some PWD, particularly many with type 2 diabetes who do not take medications associated with increased hypoglycemia risk, BGM remains more easily accessible and more affordable than CGM and can adequately meet their needs. In addition, PWD who use CGM still need to periodically use BGM. This publication reviews key issues related to the optimal and most cost-effective use of BGM. The authors address the accuracy of modern glucose meters and the recommended frequency of monitoring for people with different types of diabetes and therapeutic regimens. They suggest strategies for using glycemic data to inform therapy adjustments, as well as ways to overcome common barriers to BGM use. They then review the use of BGM in patients who also use CGM and describe the latest related technological innovations, including Cloud-based data management, mobile applications, insulin calculators, and remote and automated counseling systems. The authors conclude that BGM remains an important tool in diabetes management, even as diabetes management technologies continue to evolve.