The Endocrine Society has published a clinical practice guideline for acromegaly, a condition caused by excessive growth hormone (GH) secretion. The guideline provides recommendations for diagnosis, management, and treatment of acromegaly, including biochemical assessment, therapeutic algorithms, and management during pregnancy. The guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to assess the strength of recommendations and quality of evidence. The Task Force included experts in the field, a methodologist, and was supported by the European Society of Endocrinology. The guideline emphasizes the importance of biochemical testing, particularly IGF-1 levels, in diagnosing acromegaly. It also recommends imaging studies, such as MRI, to assess tumor size and location. The guideline outlines surgical and medical treatment options, including transphenoidal surgery, somatostatin receptor ligands (SRLs), and pegvisomant. It also addresses the management of comorbidities such as hypertension, diabetes, and sleep apnea, and provides recommendations for monitoring and follow-up. The guideline emphasizes the importance of maintaining consistent GH and IGF-1 assays throughout treatment and highlights the need for regular monitoring of liver function tests in patients receiving pegvisomant. The guideline also provides specific recommendations for patients with gigantism and those during pregnancy. The guideline is evidence-based and aims to improve the diagnosis and management of acromegaly.The Endocrine Society has published a clinical practice guideline for acromegaly, a condition caused by excessive growth hormone (GH) secretion. The guideline provides recommendations for diagnosis, management, and treatment of acromegaly, including biochemical assessment, therapeutic algorithms, and management during pregnancy. The guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to assess the strength of recommendations and quality of evidence. The Task Force included experts in the field, a methodologist, and was supported by the European Society of Endocrinology. The guideline emphasizes the importance of biochemical testing, particularly IGF-1 levels, in diagnosing acromegaly. It also recommends imaging studies, such as MRI, to assess tumor size and location. The guideline outlines surgical and medical treatment options, including transphenoidal surgery, somatostatin receptor ligands (SRLs), and pegvisomant. It also addresses the management of comorbidities such as hypertension, diabetes, and sleep apnea, and provides recommendations for monitoring and follow-up. The guideline emphasizes the importance of maintaining consistent GH and IGF-1 assays throughout treatment and highlights the need for regular monitoring of liver function tests in patients receiving pegvisomant. The guideline also provides specific recommendations for patients with gigantism and those during pregnancy. The guideline is evidence-based and aims to improve the diagnosis and management of acromegaly.