Acromegaly is a chronic, invalidating disease due in over 95% of cases to a growth hormone (GH) secreting pituitary adenoma. Its clinical manifestations are associated to local complications related to the tumor growth and/or to the metabolic consequences of GH excess. We report here our experience on 154 acromegalic patients. Surgical remission rate using stringent biochemical criteria was 32%, a figure relatively low due to the great number of patients bearing macroadenomas with invasive complications. Primary or adjuvant radiotherapy was able to obtain normalization of biochemical parameters in as much as 65.4% of treated patients. In only 14.0% of acromegalics drug therapy with dopaminergic agents was effective in controlling the disease. By contrast, somatostatinergic analogues were more effective, obtaining a clinical and biochemical remission in 45.7% of the patients. In summary, multimodal therapy of acromegaly can lead to a global safe control of the disease in 55.2% of the cases. The ongoing development of new drugs represents promising alternatives in the management of this disabling condition.