Cachexia is characterized by reduced food intake, muscle and adipose tissue loss associated with increased energy expenditure. Cachexia is highly prevalent and represents one of the main causes of increased morbidity, mortality and reduced quality of life in chronic diseases. Ghrelin plays an important role in stimulating and controlling hunger and maintaining energy homeostasis acting on central nervous system and on peripheral tissues. Most of the studies have been conducted in experimental settings and in cancer and uremic patients, showing interesting results in the treatment of cachexia. Further investigations are mandatory to obtain more definitive and conclusive results.