PURPOSE OF REVIEW It has recently been recognized that cholesterol homeostasis is fundamentally important for appropriate insulin secretory function of beta-cells in the pancreas. This review summarizes recent advances in understanding the relationship between beta-cell cholesterol metabolism and beta-cell function. RECENT FINDINGS The accumulation of cholesterol in beta-cells causes perturbations in glucose metabolism, reduces insulin secretion and can be associated with a diabetic phenotype. Cholesterol is also a key determinant of beta-cell membrane organization and cell survival. The ATP-binding cassette transporter A1, which effluxes cholesterol to lipid-free/lipid-poor apolipoprotein A-I, the principal apolipoprotein in HDLs, is crucial for maintaining beta-cell cholesterol homeostasis and function. There is also evidence suggesting that different lipoprotein classes have varying effects on beta-cell function and survival. SUMMARY Cholesterol is important for beta-cell function and survival. It can cause beta-cell loss if allowed to accumulate in the cells in an unregulated manner. The maintenance of beta-cell cholesterol homeostasis, therefore, is important for preventing beta-cell dysfunction, the onset of insulin resistance and the development of type 2 diabetes.