Ghrelin is a peptide hormone predominantly produced in the stomach. Ghrelin expression has also been reported in other tissues including the pancreas. We have reported that ghrelin cells constitute a novel endocrine cell type in the human and the developing rat islets. The cells are most numerous pre- and neonatally and, in humans, constitute 10% of all islet cells from mid-gestation to birth. Since gastric ghrelin expression is low before birth, the islets may be the main source of circulating ghrelin during this time. In the present investigation, we have performed an ultrastructural analysis of pancreatic ghrelin cells in human fetuses by using transmission electron microscopy and immunogold labelling. In addition, morphometrical analysis of secretory granules size was performed. Our data provide evidence for the unique ultrastructural features of ghrelin cells versus other islet cells. Notably, the secretory granules of ghrelin cells were of small size with a mean dense-core diameter of 110 nm. We conclude that ghrelin cells constitute a novel islet cell type, distinct from the previously hormonally characterised islet cell types.