Somatostatin is a tetradeca peptide hormone produced by many different endocrine cells throughout the body. It is also present in both the central and peripheral nervous system. The peptide has many different moods of action including inhibition of hormone secretion and influence on gastrointestinal motility. Somatostatin was identified in 1973 and about 10 years later the first long-acting analogue, octreotide, became available for use in clinical trials. Somatostatin analogues have been used to treat patients with neuroendocrine tumors, such as carcinoid tumors and endocrine pancreatic tumors, with symptoms due to excessive hormone production. It also has a well-documented effect on hormone levels and symptoms in acromegalic patients, while the use in diabetes mellitus is less well established. Several new analogues have been developed and tested for clinical use and lately non-peptide analogues have been produced. These new somatostatin receptor subtype specific analogues will soon be tested in clinical trials. In this review article the development of new analogues and new preparations of old analogues and their use in the clinic is discussed.