Early puberty is not well defined in paediatric endocrinology. This chapter reviews the current insights on definitions, patient groups and treatment modalities in girls with early puberty. It is concluded that there is no clear evidence for a beneficial effect of gonadotrophin releasing hormone agonist (GnRHa) treatment in auxological terms. A clinical approach is presented, including both auxological and psychological items. Further research is needed to answer the question of whether early puberty should be treated with GnRHa.