Creatine has become one of the most popular nutritional ergogenic aids for athletes. Studies have consistently indicated that creatine supplementation increases muscle creatine and phosphocreatine concentrations by approximately 15-40%, enhances anaerobic exercise capacity, and increases training volume leading to greater gains in strength, power, and muscle mass. In addition, a number of potential therapeutic benefits have been reported in clinical populations. Consequently, creatine supplementation is not only a popular dietary strategy used to optimize training and performance of athletes but also has increasing become a nutritional strategy to promote general health and/or provide therapeutic benefits to clinical populations. The purpose of this review is to provide an update to the current literature regarding the potential role that creatine supplementation may play in exercise, sport, and medicine.