Purpose or Case Report: Primary amenorrhea, defined as failure to reach the first menstrual cycle by the age of 15 or 3 years after breast development, presents a complex diagnostic challenge. From congenital anomalies to endocrine disorders, there is a wide range of potential etiologies; therefore, a multidisciplinary and comprehensive approach is crucial for accurate and timely diagnosis and management. Radiologic imaging often plays an important role in this process, particularly in the identification of structural abnormalities and assessing the presence of internal reproductive structures that can guide potential management decisions. In this educational exhibit, we will review etiologies of amenorrhea and their associated radiologic imaging, utilizing examples from our institution. Additionally, we aim to provide key findings and tips that can help the pediatric radiologist have a clearer understanding of the clinical questions that gynecologists seek to answer when ordering imaging for the evaluation of primary amenorrhea.
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