Premature ovarian failure remains a multifactorial syndrome in which genetic, immune, and environmental factors may play a role. The possible etiology and pathophysiology of premature ovarian failure is reviewed. A scheme of the management of premature ovarian failure is illustrated. This allows a logical approach in which the final diagnosis has to be made with laparotomy ovarian biopsy. It is hoped that future research can be directed to the solution of the etiology of premature menopause and insensitive ovary syndrome, as well as the management of patients with insensitive ovary syndrome, so that either by estrogen replacement or stimulation with hypothalamic/pituitary hormone these primordial follicles can be induced to develop normally.