The absence of a significant positive association between ovarian follicular cysts and sexual precocity in children has been the subject of many reports which affirm that such cysts are not responsible for premature onset of pubarche.1-4 Nonfunctioning ovarian cysts are commonly seen in autopsy specimens in normal children of all ages, and are considered to be physiologic.5-7 In a review of sections of the ovary in 35 patients from birth to age 7 years who exhibited no endocrinopathy, we noted physiologic cysts in almost all microscopic sections. Moreover, it appears that the extent of cystic enlargement is no criterion of ovarian activity since there are reports of large ovarian cysts, causing mechanical difficulties, which are neither functioning, autonomous nor associated with sexual precocity.8-18 Finally, Novak19 emphasized that such ovarian cysts do not function independently, following his experience with puncture of cysts in patients with constitutional sex