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Gestational diabetes is a common condition during pregnancy. This condition is associated with significant fetal and neonatal morbidity, as well as considerable costs. The management of gestational diabetes has traditionally relied on dietary hygiene and insulin therapy. Oral antidiabetic drugs have been gradually introduced into the therapeutic panel and remain a subject of debate among physicians. Our work aims to reinforce data in the literature regarding the use of glibenclamide in the treatment of gestational diabetes. Materials and methods: We carried out a prospective cohort involving two groups of patients with gestational diabetes requiring hypoglycemic treatment, the first group receiving glibenclamide (forty-one patients) and the second group receiving insulin (40 patients). Results: Our study showed that these two therapies gave comparable results in terms of glycemic control and neonatal outcome, without increasing the risk of fetal or perinatal complications. Conclusion: Glibenclamide could replace insulin in the treatment of gestational diabetes, while recalling that its use during pregnancy remains off-label.