The symptoms of growth hormone defi ciency and growth hormone excess clinically impose differently before and after the completion of longitudinal growth. Always, however, biochemical diagnostics is based on the measurement of circulating concentrations of growth hormone and insulinlike growth factor I (IGF-I). Immunoassays are practical, sensitive, and mostly specifi c methods for measuring either hormone. There are, however, still serious discrepancies between the results reported from different assays. These discrepancies are mainly due to differences in the isoform specifi city of assays, the use of different standard preparations, as well as the interference of binding proteins. The method-related differences in measured results make the general application of published diagnostic decision limits more diffi cult. At an interdisciplinary consensus conference, with the participation of the Growth Hormone Research Society, the IGF Society, and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), the existing problems were analyzed and possible strategies were highlighted to improve the comparability between results obtained from different GH and IGF-I assays. Currently, however, the use of method-specifi c reference ranges obtained from well-characterized cohorts continues to be essential in clinical practice.