The insulin-like growth factor system is complex with two major IGF ligands and at least three receptors mediating ligand-induced cell proliferation, survival, differentiation, metabolism and migration. Specific, high affinity IGF binding proteins (IGFBPs) can enhance or inhibit IGF action, as well as have IGF-independent effects. In addition, there are IGFBP proteases that alter IGFBP structure and function and, hence, IGF action. This conference will cover the spectrum of the IGF system from basic biology to clinical interventions, with emphasis on current ‘burning questions’ and novel findings. We will explore recent discoveries about how the IGF system components function as endocrine, paracrine, autocrine, and intracrine factors. The conference will present new insights into the role of the IGFs in development, organ system physiology and aging, and will focus on recent developments in IGF research relevant to major health issues including cancer, diabetes, cardiovascular disease and neurodegeneration.