Recombinant human growth hormone (GH) has been available for the treatment of growth failure in children with chronic kidney disease (CKD) for almost two decades. Controlled and open-labeled studies have shown that GH is highly effective in improving growth velocity and final height in prepubertal patients. Catch-up growth is negatively associated with age, duration of dialysis therapy and positively associated with primary renal disease (renal hypoplasia). After renal transplantation children also show sustained catch-up growth and increased final height. Recent studies have shown that GH is also effective in infants and pubertal patients. The optimal strategy on the use of GH for pediatric CKD patients is discussed in view of the recent literature.