Background/Aim: Therapy for idiopathic reactive hypoglycemia is ineffective and impractical. Acarbose, an α-glucosidase inhibitor, decreases the absorbed glucose load. This study was done to determine the efficacy of acarbose in this syndrome. Methods: Six patients with symptoms suggestive of postprandial hypoglycemia were chosen consecutively. Three-hour oral glucose tolerance tests using 75 g of glucose were done on each patient. The patients were then treated with acarbose with each meal. Results: All patients had symptomatic hypoglycemia during testing. After 4 weeks of acarbose therapy, all patients were asymptomatic on a regular diet. Conclusion: Acarbose is efficacious in the management of idiopathic reactive hypoglycemia.