Regucalcin was initially discovered in 1978 as a regulatory protein in calcium signaling. The regucalcin gene, which is localized on the X chromosome, is found in vertebrate and invertebrate species. Regucalcin has been shown to play a pivotal role in cell regulation: maintaining of intracellular calcium homeostasis, suppressions of signal transduction, inhibition of translational protein synthesis, nuclear deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) synthesis, regulation of gene expression, and anti-effects on proliferation and apoptosis in many cell types. The expression of the regucalcin gene and its protein has been shown to alter with various metabolic diseases, and regucalcin plays an important role in the development of many pathophysiologic states. Serum regucalcin has been found to increase with liver injury, and also urinary regucalcin is elevated with kidney damage, suggesting a useful tool as biomarker for diagnosis. Moreover, regucalcin has been shown to be good tool in early diagnosis for Alzheimer's disease and other brain diseases. This review will discuss a significance of regucalcin as a clinical biomarker in various diseases.