The availability of recombinant human growth hormone (GH) has expanded the use beyond growth hormone deficiency (GHD) to conditions that include, use in anti-aging formula and in sports to enhance athletic performance. The long-term safety and efficacy of GH use for these conditions has not been demonstrated. The objective of this review is to explore evidence from clinical and epidemiological studies to determine the safety of GH and current updates on any adverse effects including cancer risk. The primary concern with GH use for healthy adults without proven GHD is the lack of long-term studies evaluating its safety and efficacy. An association with cancer has been shown in limited studies that highlight the need for caution on long term use in healthy adults without GHD. GHD efficacy has not been established in anti-aging or enhancing athletic performance but adverse effects have been documented in these uses.