Ever since its discovery in 1953 by N. O. Kaplan and coworkers, the physiological role of the proton-translocating transhydrogenase has generally been assumed to be that of generating mitochondrial NADPH. Mitochondrial NADPH can be used in a number of important reactions/processes, e.g., biosynthesis, maintenance of GSH, apoptosis, aging etc. This assumed role has found some support in bacteria but not in higher eukaryotes, a situation which changed dramatically with two recent but separate findings, both using transhydrogenase knockouts, in the nematode C. elegans and the mouse strain C57BL/6J. The latter, which is due to a spontaneous deletion mutation in the Nnt gene, was serendipitously found during investigations of the diabetic properties of these mice. The implications of these findings for the overall role of transhydrogenase in cell metabolism and disease are discussed.