Insulin-like growth factor-I (IGF-I) is one of the important molecule that has driven great interest in gerontology. The connection between IGF-I and the replacement therapy has been the center for many investigations for the past decade. IGF-I levels decline with age and has been considered to contribute to age-related decline in body activities. As adults age, there is a decline in the concentration of IGF-I. It has been postulated that the declines in both growth hormone (GH) and IGF-I, as it is evident in aged adults, may be associated with increased body fat, reduced muscle strength, decreased bone mass, and reduced lean body mass. This reduction may lead to overall body performance and thus may decrease the quality of life. In the present review, we have viewed the past history of the relevant publications to find a perception that would lead us to come close to the idea of the therapeutic step and provide a view of a possible IGF-I replacement therapy in the healthy elderly subjects. More specifically, this review will summarize and help to understand the effects and benefits of IGF-I system impacting on the aged organ systems. In addition, we aim to discuss the general functional properties of IGF-I and implications of its possible use as a replacement to the healthy elderly subjects and we will emphasis its downfalls and new perceptions.