This video demonstrates the preoperative assessement and operative management of female children with ambiguous genitalia. The technique of posterior-flap vaginoplasty and two methods of reduction clitoroplasty are demonstrated in two patients: one with 21-OH deficiency congenital adrenal hyperplasia and the other with mixed gonadal dysgenesis (MGD). Also shown is the abdominal exploration of the second patient which revealed the classic finding of MGD.