Background: Precocious puberty (PP) is a common pediatric endocrine problem. It is a complex and a multifactorial. Design and settings:A retrospective hospital based study was conducted at King Khalid University Hospital (KKUH), Riyadh Saudi Arabia, during the period January 1990 and December 2016. Materials and Methods: During the period under review, all patients with the diagnosis of peripheral precocious puberty were reviewed for age, sex, clinical characteristics, hormonal and radiological investigations. Results: During the period under review; 19 patients were evaluated for PPP. Elevated levels of estradiol or testosterone levels with suppressed gonadotropin levels on GnRH stimulation test. Various etiological causes were noted, with congenital adrenal hyperplasia (8 patients) and hypo-thyroidism (5 patients) being the commonest. Adrenal tumors in 3 patients, ovarian pathology in two and McCune-Albright Syndrome was the diagnosis in one. Conclusion: Peripheral precocious puberty wasnâ€™t that rare in our series. Variety of causes with congenital adrenal hyperplasia and hypothyroidism were the commonest.