Aldose Reductase (ALR2) is defined as the first enzyme of the “polyol pathway”. As such, ALR2 would convert glucose to sorbitol through an NADPH dependent reaction. Considered a promoter of osmotic imbalance under hyperglycemic conditions, the enzyme has been under intense investigation as a critical target to prevent and control diabetic complications through the inhibition of its activity. Further characterization of ALR2 suggests its participation in cell detoxification mechanisms through the reduction of toxic aldehydes. Moreover, intriguing is the apparent involvement of the enzyme in the signalling machinery of inflammatory cell response. Here, the structural and functional assessment of ALR2 as an aldose/aldehyde reducing enzyme, and its involvement in various aspects of cell function from sugar metabolism to redox homeostasis and cell signaling are presented.