Insulin stimulates glucose uptake into the target tissues of fat and muscle by recruiting or translocating Glut4 glucose transport proteins to their functional location at the cell surface. In the basal state, Glut4 is sequestered intracellularly in several vesicular compartments, one of which has come to be known as Glut4 storage vesicles (GSVs). The GSVs represent a tissue-specific compartment that is an ultimate target of the insulin signalling cascade. Glut4 translocation has been extensively studied because of its intrinsic scientific importance to cell biology as well as its relevance to the pathology of type 2 diabetes mellitus. I review herein the ontogeny of GSVs and their composition as it relates to a tissue-specific, hormone-sensitive exocytic compartment and propose a mechanism for their formation.