Fasting during Ramadan, one of the five pillars of Islam, is an obligatory duty for all healthy adult Muslims. Ramadan, a lunar month, can last for 29 or 30 days, and its timing changes with respect to seasons. Depending on the geographical location and season, the duration of the daily fast may range from a few to 20 hours. Muslims who fast during Ramadan must abstain from eating, drinking, taking oral medications, and smoking from before dawn until after sunset; there are no restrictions on food or fluid intake between sunset and dawn. Mahmoud Ashraf Ibrahim describes the challenges of fasting for people with diabetes and their healthcare providers, and offers some important considerations for ensuring people’s health and well-being during Ramadan.