Prolactin response after domperidone (DOM) stimulus was used to investigate the functional status of the hypothalamo-hypophyseal axis in 57 congenital growth-hormone-deficient (GHD) children with and without magnetic resonance imaging (MRI) abnormalities. Response to DOM was significantly lower in the GHD children compared with controls, using maximum peak (p < 0.0001), increase (p < 0.0001) or percentage increase (p < 0.05). The lowest values were observed in patients with hypophyseal stalk transection. Thus, the DOM test revealed reduced dopaminergic transmission in GHD subjects, more severe in the transected group, in whom, however, a response to the stimulus was still present. Therefore, it seems that a residual hypothalamo-hypophyseal connection is preserved even if it is not detectable with MRI.