The T-box transcription factor T-bet (Tbx21) has emerged as a key regulator of type 1-like immunity, playing critical roles in the establishment and/or maintenance of effector cell fates in T and B lymphocytes, as well as dendritic cells and natural killer cells. Several autoimmune diseases, especially those classically considered related to T helper 1 (Th1) immunity, appear to require T-bet, at least as judged in mouse models. This review summarizes a current understanding of T-bet's role in immunity, as well as its importance in autoimmunity, with implications for therapeutic intervention.