Although HbA1c remains a valuable metric for assessing glycemic control, its limitations are well recognized. Time in range (TIR) of 70-180 mg/dL (3.9-10 mmol/L) has been popularized as an important measure of glycemic control for clinical trials and diabetes management. Surveys have shown that TIR is recognized as an important outcome by patients. Using data from the Diabetes Control and Complications Trial, it has been shown that TIR calculated from quarterly 7-point blood glucose measurements is strongly associated with the development or progression of retinopathy and microalbuminuria. For each 10 percentage points lower TIR, the rate of development of retinopathy progression was increased by 64% and the rate of development of the microalbuminuria outcome was increased by 40%. A study from China also has demonstrated a strong association between TIR and retinopathy in type 2 diabetes. The strength of the association of TIR with microvascular complications appears to be of similar magnitude to that of HbA1c with complications. Based on these findings, a compelling case can be made that TIR is strongly associated with the risk of microvascular complications and should be an acceptable endpoint for clinical trials as well as a valuable metric in the clinical care of people with diabetes.