Since their introduction into clinical practice, somatostatin analogs have been the medical therapy of choice for the treatment of acromegaly. Therefore, considerable data exist on their use for this purpose. This review summarizes the literature on somatostatin analog therapy of acromegaly and describes its efficacy in terms of the main goals for the treatment of acromegaly, i. e. normalization of hormone levels, GH and IGF-I, relief of the signs and symptoms of acromegaly, and pituitary tumor shrinkage. The side effects of somatostatin analogs and their role as primary therapy for acromegaly are also discussed. The review focuses on the data with the depot analogs because these formulations are most likely to be chosen in clinical practice.