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Ghrelin exerts key effects on islet hormone secretion to regulate blood glucose levels. Here, we sought to determine whether ghrelin's effects on islets extend to the alteration of islet size and [beta] cell mass. We demonstrate that reducing ghrelin - by ghrelin gene knockout (GKO), conditional ghrelin cell ablation, or high-fat diet (HFD) feeding - was associated with increased mean islet size (up to 62%), percentage of large islets (up to 854%), and [beta] cell cross-sectional area (up to 51%). In GKO mice, these effects were more apparent in 10- to 12-week-old mice than in 4-week-old mice. Higher [beta] cell numbers from decreased [beta] cell apoptosis drove the increase in [beta] cell cross-sectional area. Conditional ghrelin cell ablation in adult mice increased the [beta] cell number per islet by 40% within 4 weeks. A negative correlation between islet size and plasma ghrelin in HFD-fed plus chow-fed WT mice, together with even larger islet sizes in HFD-fed GKO mice than in HFD-fed WT mice, suggests that reduced ghrelin was not solely responsible for diet-induced obesity-associated islet enlargement. Single-cell transcriptomics revealed changes in gene expression in several GKO islet cell types, including upregulation of Manf, Dnajc3, and Gnas expression in [beta] cells, which supports decreased [beta] cell apoptosis and/or increased [beta] cell proliferation. These effects of ghrelin reduction on islet morphology might prove useful when designing new therapies for diabetes., Introduction Ghrelin is secreted primarily by gastric ghrelin cells (1). It is mainly via binding to CNS and pituitary growth hormone secretagogue receptors (GHSRs) that ghrelin's actions to increase GH [...]