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Objective To evaluate spermatogenesis in patients with isolated GH deficiency and multiple pituitary hormone deficiencies. Design Treatment of isolated GH-deficient patients with recombinant human GH (weekly dose of 0.7 IU/kg) for 5.3 ± 0.4 (mean ± SD) years and cotreatment of multiple pituitary deficient patients with GH at the same dosage for 8.0 ± 0.4 years and hCG (2,000 IU, three times per week) and hMG (500 IU, two times per week) for 13.7 ± 1.1 months. Setting Endocrine Pediatric Unit. Patients Eight patients affected by isolated GH deficiency and seven by multiple pituitary hormone deficiencies. Main Outcome Measures Serum LH, FSH, and T, testicular volume, semen volume, density, count, and motility. Results Patients with isolated GH deficiency completed their pubertal development in 19.0 ± 3.5 months and patients with multiple pituitary hormone deficiencies in 13.7 ± 1.1 months. At the end of puberty, the two groups of patients had similar testicular volume, penis size, sperm concentration, motility, and morphology, although T levels and seminal volume were lower in isolated GH-deficient patients than in multiple pituitary deficient patients. Conclusions The two groups of patients, treated specifically for their identified hormonal deficiencies, in the end had similar satisfactory reproductive results.