Puberty refers to the achievement of reproductive maturity. It is a period of acceleration in linear growth, increase in muscle mass, and changes in ovarian and testicular function (1). The initial evaluation of the young child with early sexual development is to distinguish true central precocious puberty with activation of the hypothalamic/pituitary/gonadal axis from peripheral or gonadotropin-independent precocious puberty so that specific treatment can be initiated. The decision to treat medically the child with central precocious puberty requires an understanding of the variable progression of puberty. Hence, the evaluation of the child with central precocious puberty should identify those children who might benefit by treatment with long-acting analogs of Gonadotropin Releasing Hormone (GnRHa) to halt their pubertal progression.