This report describes the case of a 22-month-old child who was hospitalized in 1934 because of "sexual precocity and cryptorchidism". The phallus measured 4 cm in length and 4 cm in circumference. The scrotum, although empty, appeared normal. Biopsy of the right adrenal showed normal-appearing adrenal cortical tissue. At a subsequent abdominal exploration for orchidoplasty neither testes nor cord were found, instead well-formed fallopian tubes, ovaries and a small normal-appearing uterus were present. The child died on the 1st postoperative day. In addition to the surgical findings, autopsy showed bilateral adrenal hyperplasia and a penile urethra. Despite advances in endocrinology and refinements in laboratory procedures in the last 20 years, this case would still present a diagnostic problem today. Only a high index of suspicion would lead to the procedures necessary to establish the true gonadal status. The authors emphasize the importance of questioning the gonadal status in any individual with precocious somato-sexual development or developmental abnormalities of the external genitalia in whom testes are not palpable.