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It is a phosphate carrier. When ATP fires in the muscles it needs to replace the phosphate before it can fire again. Creatine carries the extra phosphate and stays in the muscle until it has done its job. It allows for longer, more intense workouts prior to muscle failure, which means you can get more work in in the same amount of time. It does nothing to increase the size of the muscles, just the length of the workout. It also causes water retention (I lost about 12 pounds when I quit using it). It works fine, although I would bet some of that is placebo.
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Strange women, lying in ponds, distributing swords is no basis for a system of government. If I went around claiming I was an emperor just because some moistened bink lobbed a scimitar at me, they would put me away.
-Monty Python-
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