Ghrelin is a protein hormone secreted from the gastric mucosa, but is also expressed in a variety of tissues. The biological function of ghrelin is widely known, including regulation of food intake, body weight, gastrointestinal, cardiovascular, reproductive, immune functions, cell proliferation and hormone secretion. The growth hormone secretagogue receptor (GHS-R) mediates the effect of ghrelin. Depending on cell type, ghrelin either induces apoptosis or has anti-apoptotic effect. Apoptosis is a physiological process that plays an important role in many biological actions such as proliferation, development or differentiation and regulation of physiological function in many cells. Dysfunction or dysregulation of apoptosis leads to pathology conditions. The action of ghrelin on cell apoptosis is reviewed in this paper.