Metabolic syndrome significantly increases the incidence of atherosclerosis-related diseases including coronary artery disease, stroke, and type 2 diabetes. Recent progress has demonstrated that amylin, or islet amyloid polypeptide, is circulating multifunctional hormone and neuropeptide, which is co-secreted with insulin into the bloodstream by pancreatic beta cells and plays a very important role in regulating feeding, energy homeostasis and inflammation. Recent FDA approval of amylin analog pramlintide as a new drug for treating type 1 and 2 diabetes positions amylin in the spotlight. In this analytical review, I summarize the recent progress on amylin studies in the following sections: 1) introduction to the molecular features of amylin; 2) amylin’s amyloidogenic and proinflammatory effects; 3) a satiety hormone and new drug in increasing energy expenditure; and 4) a vasodilator inducing hypotension and tachycardia; and 5) a neuropeptide in depolarizing cholinergic neurons via closure of potassium channels. Continued improvement of our understanding on this multifunctional hormone would lead to future development of pramlintide as novel therapies for other inflammatory, hematological, metabolic, neurological and vascular diseases.