Introduction: Delayed gastrointestinal (GI) transit is common in patients with severe burn. Ghrelin is a potent prokinetic peptide. We aimed at testing the effect of ghrelin on burn-induced delayed GI transit in rats. Methods: Gastric emptying, intestinal transit (IT) and colonic transit (CT) studies were performed in male SD rats. Rats were randomized into 2 main groups: sham injury and ghrelin-treated burn injury with doses of 0, 2, 5 and 10nmol/rat IP, 6 hours after burn. Sham/burn injury was induced under anesthesia. Rats received a phenol red meal twenty minutes following ghrelin injection. Based on the most effective ghrelin dose, atropine 1mg/Kg sc was given 30min before the ghrelin in one group of rats for each study. The rats in each group were sacrificed 30-90min later; their stomachs, intestines and colons were harvested immediately and the amount of phenol red recovered was measured. Percentage of gastric emptying (GE%) and geometric center (GC) for IT and CT were calculated. Results: 1) Severe cutaneous burn injury significantly delayed GE, IT and CT compared to sham injury (p<0.05). 2) Ghrelin normalized both GE and IT, but not the CT. 3) The most effective dose of ghrelin was 2nmol/rat. 4) Atropine blocked the prokinetic effects of ghrelin on GE% and IT. Conclusion: Ghrelin normalizes burn-induced delayed GE and IT but has no effect on CT in rats. The prokinetic effects of ghrelin are exerted via the cholinergic pathway. Ghrelin may have a therapeutic potential for burn patients with delayed upper GI transit.