Background: Ghrelin is a peptide produced mainly by the gut and hypothalamus. Ghrelin is able to stimulate food‐seeking behavior. Alcohol‐craving and food‐seeking behavior could share common neural circuits. Ghrelin is related to nutritional status, but few data are available in alcoholic patients on the relationship between ghrelin and nutritional disorders.Methods: Plasma ghrelin was evaluated in 15 current alcoholic male patients compared with 15 healthy male volunteers. Craving was evaluated by the Obsessive–Compulsive Drinking Scale. Body composition was assessed by dual‐energy X‐ray absorptiometry. Energy substrate utilization was evaluated by indirect calorimetry.Results: Ghrelin was significantly reduced in alcohol‐dependent patients with respect to healthy subjects (p=0.0278). A significant positive correlation was found between ghrelin and craving (r=0.55; p=0.034). A preferential utilization of lipids as an energy substrate with a reduction of the fat mass (p=0.01) and an increase of the free fat mass (p=0.0091) was found in alcoholic patients.Conclusions: Within our sample showing low ghrelin levels probably related to the impaired nutritional status; patients with higher levels of ghrelin showed higher levels of alcohol craving. These preliminary data indicate that ghrelin could be implicated in the neurobiological mechanisms of alcohol craving, other than a hormone influenced by the nutritional status.