Idiopathic short stature is defined by height below 3rd percentile, in a child with normal birth height and weight, lack of dysmorphy, endocrine deficiency or systemic disease. Food and Drugs administration approved GH treatment in this indication in the United States, because it induces height gain, and sometimes may increase quality of life. There is no consensus in terms of duration, monitoring parameters, benefits and risks of long term GH treatment in these patients. Cost effectiveness of such a treatment is under debate, and ethical considerations also have to be taken into account. Recombinant IGF1 should not be proposed in this indication at the moment, due to the lack of sufficient data on potential GH insensitivity in a subgroup of these patients.