The abuse of recombinant human growth hormone in sports is considered to be a widespread phenomenon, but until today all our knowledge thereof is based on rumor, anonymous surveys or accidental observations by customs officers. Although growth hormone (GH) is listed as a prohibited class E substance by the International Olympic Committee (IOC) no official test for the detection of GH abuse is implemented. Because of the high degree of identity in the amino acid sequence between recombinant and endogenous GH and because of the pulsatile nature of GH secretion, as well as inter-individual variations, it was believed to be undetectable. Recently, new proposals have been made to overcome this problem. On the basis of differential immunoassays it is possible to determine the relative content of GH isoforms in the circulation and thus to detect the application of recombinant GH. Furthermore, changes in GH dependent parameters after the administration of recombinant GH have been shown to be a possible indicator of GH abuse.