Aim: To improve the management of congenital adrenal hyperplasia in females and make recommendations regarding gender assignment and genitoplasty surgery in our setup. Methods: The study was carried out in department of pediatric Urology and Endocrinology, Children hospital and ICH Multan from 1st January, 2009 to December, 2018. We did retrospective analysis of records of 25 patients with ambiguous genitalia and diagnosed as a case of CAH. The clinical data, investigations surgeries performed and there outcome were reviewed. Results: Out of twenty five patients, thirteen (52%) were diagnosed as salt wasters and twelve (48%) were having simple virilization. Our ten patients (40%) were incorrectly assigned male sex at presentation. The fourteen (56%) patients had low vaginal confluence and about eleven (34%) patients had high vaginal confluence. Conclusion: Children with CAH should be diagnosed early and every possible effort should be made to assign correct gender. Early genital surgery helps in medical, psychological and social wellbeing of child in our setup.