Recombinant human growth hormone (rhGH) and GH receptor antagonists (GHAs) are used clinically to treat a range of disorders associated with GH deficiency or hypersecretion, respectively. However, these biotherapeutics can be difficult and expensive to manufacture with multiple challenges from recombinant protein generation through to development of long‐acting formulations required to improve the circulating half‐life of the drug. In this review, we summarise methodologies and approaches used for making and purifying recombinant GH and GHA protein, and strategies to improve pharmacokinetic and pharmacodynamic properties, including PEGylation and fusion proteins. Therapeutics that are in clinical use or are currently under development are also discussed.This article is protected by copyright. All rights reserved.