Local lipoatrophy is a well known complication of insulin treatment at injection sites and the etiology is thought to be a cross reaction with lipid tissues and insulin antibody. Although mild lipoatrophy during growth hormone treatment has been reported in the literature, severe local lipoatrophy in injection sites in the extremities has not yet been published. We report a patient with isolated GH deficiency due to 6.7 kb gene deletion who received high dose rhGH treatment and developed local lipoatrophies at injection sites without any antibody detection after 6 years of therapy. The etiology of the lipoatrophy is suspected to be by the direct lipolytic effect of high doses of rhGH.