In this study we compare the cosmetic and functional results of the common reconstructive techniques used in the management of patients with clitoral hypertrophy. We find impressive benefits in a surgical procedure that includes excision of the clitoral shaft with preservation of the glans and ventral mucosa combined with simple introitoplasty. We recommend reserving definitive vaginoplasty as needed until the age of puberty. Our experience is this clinical area is being offered with attention to the long-term followup of patients.