Pelvic ultrasonography (PUS) is the technique of choice for the evaluation of pediatric genital organs, as an accurate, painless, noninvasive method that does not require sedation or ionizing radiation. 1 This method allows the assessment of sexual development, in particular alterations such as premature or delayed puberty, or sexual ambiguity, among others. 2,3 The imaging appearance of the normal reproductive tract changes over the female's life, largely as a result of hormonal influence. 4 The neonatal uterus is prominent, and the cervix is larger than the fundus (fundal-cervical ratio 1:2); in contrast, the prepubertal uterus generally has a tubular shape, and