We have reviewed the use of oral agents in the management of Type 2 diabetes, together with their pharmacological mechanisms, indications, side effects and contra-indications. The principal oral agents available for use include metformin, sulphonylureas, non-sulphonylurea secretagogues (meglitinides), thiazolidinediones, and α-glucosidase inhibitors. More recently, DPP-IV inhibitors and glucagon-like peptide-1 agents have been registered for use in the United States and in Europe. They await Medicines Control Council registration for use in South Africa. This article will discuss the various oral hypoglycaemic agents, together with the newer modes of therapy, which are soon to become available in our therapeutic armamentarium in South Africa.