The PM registered the @david_cameron account on Saturday and by the early hours of Sunday morning had amassed 65,000 followers.
In his first tweet to the nation he wrote: "I'm starting Conference with this new Twitter feed about my role as Conservative Leader. I promise there won't be "too many tweets...""
The last few words of the post are a lighthearted reference to an interview in 2009, in which Cameron said: "The trouble with Twitter, the instant-ness of it - too many tweets might make a tw*t."
Later on Saturday, the PM posted a picture of himself meeting with staff at the John Radcliffe Hospital after announcing "£140m to help their work across the country."
Keeping it in the family
So far the PM has chosen to follow just four people and he's keeping it very close to home; the Mayor of London Boris Johnson, foreign secretary William Hague, health secretary Jeremy Hunt and, of course, the official Conservative Party account.
Unsurprisingly, Cameron's timeline makes for some interesting reading.
Some users have resorted to profanity-laden person abuse, while others are using the platform to challenge his policies. The rest seem to be just having a giggle.
A particular favourite was this from @JohnJonJoe, which read: "@david_cameron 25p a freddo haven't been this outraged since they stopped making Taz bars you gotta stop this madness."