The Growth hormone (GH)/IGFI-axis plays a central role in the longitudinal bone growth as well as in the acquisition and maintenance of bone mass in children. Studies, in both growth hormone excess and deficiency, suggest that growth hormone may be useful as an anabolic agent in children with osteoporosis. Growth hormone deficiency (GHD) is recognized to result in reduced bone mass, decreased bone turnover markers, secondary osteoporosis and increased fracture rate. Epidemiological studies suggest that GHD alone may explain the increased fracture rate seen in these patients. Treatment of GHD patients with GH results in an increase in turnover markers. While short-term studies showed little improvement in bone mass, longer term studies with treatment periods of 2 years or more have shown significant increases in bone mass.