Introduction: Synaptic dysfunction and degeneration are early fundamental pathophysiological characteristics of Alzheimer’s disease (AD). In addition, synaptic depletion closely correlates with clinical disease severity. Biomarkers that may track synaptic dysfunction in AD are eagerly awaited. Areas covered: Here, we reviewed the significance of the post-synaptic protein neurogranin – particularly enriched in dendritic spines – as a biomarker of early synaptic dysfunction in AD.