The aim of the present study was to assess the influence of regular physical activity on plasma ghrelin concentration in pre-pubertal and pubertal boys. In addition, the impact of ghrelin concentration on bone mineral density (BMD) was examined. In total, 56 healthy schoolboys aged between 10 and 16 yr were divided into the swimming (no.=28) and the control (no.=28) groups. The subjects were matched by age and body mass index (BMI), generating 9 matched pairs in pubertal group I (Tanner stage 1), 11 pairs in group II (Tanner stages 2 and 3), and 8 pairs in group III (Tanner stages 4 and 5). Swimmers in pubertal groups II and III had significantly (both p<0.05) higher mean ghrelin levels than the controls (group II: 1126.8+/-406.0 vs 868.3+/-411.2 pg/ml; group III: 1105.5+/-337.5 vs 850.8+/-306.0 pg/ml, respectively), whereas no difference was seen in the pubertal group I (1230.8+/-386.0 vs 1272.7+/-424.4 pg/ml). Ghrelin was the most important hormonal determinant for total BMD and lumbar apparent volumetric BMD (BMAD) (R2=27.2% and R2=19.8%, respectively) in swimmers, whereas in control boys, plasma IGF-I was the most important hormonal predictor accounting for 41.8% of the variability of total BMD and 20.4% of the variability of lumbar BMAD. In conclusion, ghrelin concentration decreased during puberty in physically inactive boys, while in regularly physically active boys it remained relatively unchanged. Ghrelin appears to be an important hormonal predictor for BMD in physically active boys, while BMD is mostly determined by IGF-I in physically inactive boys.