The gonadal histopathology, and its correlation with the clinical features has been investigated in 9 true hermaphroditism patients, aged 5-21 yr. Seven of 9 patients had been raised as females, of which the chromosomal karyotype was 46XX in 5 cases, 46XX/46XY and 46XX/47XXY in 2 cases. Two of 9 pa- tients were raised as males, the chromosomal karyotypes being 46XX and 46XX/46XY. All 9 patients had testicular tissue excised, and biopsies of the conserved ovarian tissue were performed. Ovotestis was the most common form of the abnormal gonads; two of 9 patients had bilateral ovotestes, seven had unilateral ovotestes (5 in right side, 2 in left side). In seven patients with a unilateral ovotestis, 6 had a contralateral ovary and one had a contralateral testis. Microscopically, the ovarian tissue of 11 ovotestes, including 6 biopsies from contealateral ovaris, were normal, with many primordal follicles and a few growing follicles. In two of the patients, aged over 15 years, evidence of ovulation was observed. In comparison, the testicu- lar tissue of the ovotestis and the one left inguinal testis was histologically abnormal, with immature semi- niferous tubules, most of which filled with Sertoli cells only. Three of 9 patients married after surgical treatment. Two of these subsequently conceived and delivered of normal infants by cesarean section. The gonadal histopathology, and its correlation with the clinical features has been investigated in 9 true hermaphroditism patients, aged 5-21 yr. Seven of 9 patients had been raised as females, of which the chromosomal karyotype was 46XX in 5 cases, 46XX / 46XY Two of 9 pa- tients were raised as males, the chromosomal karyotypes being 46XX and 46XX / 46XY. All 9 patients had had testicular tissue excised, and biopsies of the conserved ovarian tissue were performed. Ovotestis was the two of 9 patients had bilateral ovotestes, seven had unilateral ovotestes (5 in right side, 2 in left side). In seven patients with a unilateral ovotestis, 6 had a contralateral ovary and one had a contralateral testis. Microscopically, the ovarian tissue of 11 ovotestes, including 6 biopsies from contealateral ovaris, were normal, with many primordal follicles and a few growing follicles. In two of the patients, aged over 15 years, evidence of ov ulation was observed. In the testicu- lar tissue of the ovotestis and the one left inguinal testis was histologically abnormal, with immature semi- niferous tubules, most of which filled with Sertoli cells only. Three of 9 patients married after surgical treatment. Two of the following consequent and delivered of normal infants by cesarean section.