BACKGROUND Increased generation of free radicals from protein glycation has been associated with compromised integrity of erythrocytes in diabetes. Musa sapientum has been reported to possess anti-diabetic properties and this study investigated the effect of methanol extract of Musa sapientum on protein glycation and erythrocyte integrity. METHODS Forty-two male Wistar rats (180-200g) were randomly grouped into seven: 1 (control), 2 (diabetic untreated), 3 (normal extract-treated (250 mg/kg)), 4 (normal metformin-treated (150 mg/kg)), 5 (diabetic extract-treated (250 mg/kg)), 6 (diabetic metformin-treated (150 mg/kg)), 7 (diabetic insulin-treated (1 IU/kg)). Diabetes was induced with single intraperitoneal injection of 120 mg/kg alloxan. Animals were treated for 14 days and blood (3 mls) was collected from retro-orbital plexus to determine serum fructosamine level, erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities. Glycated haemoglobin (HbA(1c)) level was estimated using a conversion formula. Animals were sacrificed thereafter by cervical dislocation and pancreatic tissues were excised and stained with haematoxylin and eosin for histological study. Statistical significance at P < 0.05 was analyzed by one-way ANOVA and Newman-Keuls' post-hoc test. RESULTS Diabetic rats treated with extract, metformin and insulin had significant reduction in serum fructosamine level by 62.64%, 74.63% and 56.05% respectively while HbA(1c) level reduced by 45.06%, 50.62% and 40.57% respectively. Activities of erythrocyte SOD and GPx were increased in the extract-treated group. Histological studies showed regeneration of islet cells in the diabetic extract-treated rat which was comparable to normal. CONCLUSIONS The extract inhibited protein glycation, regenerated the islet cells and improved erythrocyte antioxidant status in diabetic rats.