The insulin-like growth factor-1 (IGF-1) is a pleiotropic factor. Many studies have revealed its importance in the development and maintenance of the central nervous system (CNS). This review will discuss the IGF-1 axis, from the factor itself to the signalling pathways it activates, and its tight regulation. Particular focus will be brought on potential therapeutic targets of the IGF-1 axis in CNS disorders, including brain tumours and neurodegenerative diseases affecting neurons and oligodendrocytes.