Progranulin (PGRN), a widely expressed glycoprotein with pleiotropic function, has been linked to a host of physiological processes and diverse pathological states. Currently, various therapeutic strategies targeting PGRN have been developed in a series of preclinical models of diseases and clinical trials, highlighting PGRN as a promising target in diseases treatment. Herein we summarize available knowledge of PGRN targeting in various kinds of diseases, including common neurological diseases, inflammatory autoimmune diseases, cancer, tissue repair, and rare lysosomal storage diseases, with the focus on the functional domain-oriented drug development strategies. In particular, we emphasize the potential role of PGRN as a non-conventional, extracellular matrix bound, growth factor-like conductor orchestrating multiple membrane receptors and simultaneously as an intracellular co-chaperone.