Leg cramps are involuntary painful contractions that usually occur in the calf, but may sometimes affect the thighs or feet. These episodes can last anywhere from few seconds to 10 minutes and then remit spontaneously. Tenderness and pain can last for several hours after cramping. Electromyography during leg cramps shows bursts of high-voltage and high frequency discharges. Spontaneous firing of groups of anterior horn cells, followed by contraction of motor units, has been implicated in the pathophysiology. A vast array of treatments, both non-pharmacologic and pharmacologic, has been used in an attempt to treat nocturnal leg cramps. The idea of trying vitamin E for nocturnal leg cramps came from an incidental finding when patients taking vitamin E report relief from cramping. Gabapentin significantly reduces leg cramps in patients with neurologic diseases, but its usefulness in idiopathic leg cramps remains to be seen.