Until recently, adult patients with hypopituitarism did not receive growth hormone in complex hormonal replacement therapy. It was assumed that growth hormone had no physiologic relevance after cessation of growth and its deficiency was not regarded as a clinical problem. Only in last 2 decades important metabolic effects of growth hormone in adults were revealed. The availability of recombinant human growth hormone enabled the description of adult growth hormone deficiency syndrome. Its typical signs include central adiposity, reduced muscle mass and strength, emotional lability, depressed mood, impaired sense of well-being and quality of life. Hyperlipidaemia, insulin resistance and endothelial dysfunction contribute to premature atherosclerosis and higher mortality due to cardiovascular diseases. Growth hormone replacement therapy is safe and effective and improves all symptoms and signs of growth hormone deficiency.