Although there have been Pediatric and Adolescent Gynecology (PAG) fellowships since the 1980s, PAG has not been recognized as a subspecialty in Obstetrics and Gynecology until more recently. The Fellowship program at MedStar/Childrens National started in 2010 was the fourth in North America, and in 2018 there are 13 such programs. As of October 2018, the American Board of Obstetrics and Gynecology has begun to provide Special Certification in Pediatric and Adolescent Gynecology. We anticipate that soon every pediatric hospital in the United States will be required to have a pediatric Gynecology Service. In July of 2018, we plan to transition the Pediatric and Adolescent Gynecology Program from MedStar/Childrens National to be housed at NICHD. Pediatric and Adolescent Gynecology is closely related to Reproductive Endocrinology and thus this program will be synergistic with the existing Fellowship in Reproductive Endocrinology and Infertility. The NICHD Fellowship in Pediatric and Adolescent Gynecology (PAG) is comprised of faculty from three institutions: The National Institute of Child Health and Human Development (NICHD), MedStar Washington Hospital Center (MWHC) and Childrens National Health System (CNHS). Previously housed at MedStar Washington Hospital Center, the Pediatric and Adolescent Gynecology Fellowship has been training fellows since 2010 with the mission to ensure the graduate possesses the knowledge, skills, and professional attributes essential to be able to function as a consultant to pediatricians, family practitioners, obstetricians and gynecologists for girls from birth up to age 18-21 years with pediatric gynecologic concerns as well as older women born with congenital anomalies.