Profiling and monitoring concentrations of key hormones in body have long been critical aims in clinical therapy. As a crucial hormone, identification and quantification of ghrelin is a fundamental, often key, step in understanding human physiological mechanisms. Through the advances and improvements of different analytical techniques, ghrelin measurement is generally feasible, and the number of successful reports is progressively being increased with new aspects of selectivity, sensitivity and ease of use in various circumstances. Herein we discuss current chromatographic methods for sample collection, separation and a mass spectrometry method for detection and measurement of ghrelin and other proghrelin-derived peptides in biological metrics. We describe the most commonly applied analytical LC-MS procedures for determination of proghrelin-derived peptides and provide illustrative instances representing the state of the art. This review is intended for bioanalytical chemists or clinical researchers who are interested in this field of research.