Aldo-Keto Reductases (AKRs) are a rapidly growing gene superfamily involved in the formation of hyperosmotic sugars, which can contribute to diabetic complications. They also metabolize reactive aldehydes, prostaglandins, steroid hormones, chemical carcinogens and drugs. These enzymes (>115) are generally monomeric, cytosolic, NAD(P)Hdependent-oxidoreductases, that share high sequence identity -(<40%) and similar three-dimensional-structures e.g., (α/β) 8 -barrels and belong to 14 families. For a complete listing of the 14 families visit: www.med.upenn.edu/akr. AKRs detoxify endogenous toxicants, e.g., cytotoxic/mutagenic bifunctional electrophiles derived from the decomposition of lipid hydroperoxides. AKRs also metabolize exogenous toxic substances. They play a role in tobacco-carcinogenesis since they catalyze the detoxication of nicotine derived nitrosaminoketones and activate polycyclic aromatic trans-dihydrodiols to yield reactive and redox active ortho-quinones. Discrete isozymes also detoxify mycotoxin metabolites, e.g., aflatoxin dialdehyde and protect against hepatocellular carcinoma. The aflatoxin reductases are induced by cancer chemopreventive agents, e.g., ethoxyquin. Evidence is mounting that AKRs are stress regulated genes and play a central role in the cellular response to osmotic, electrophilic and oxidative stress.