In women, androgens are produced by the ovaries and the adrenal gland as well as the periphery. Testosterone is a critical hormone for women’s health. Testosterone improves sexual function, bone health, mood, behavior, and cognition. More importantly, testosterone serves as precursors for the biosynthesis of estrogens. The circulating levels of testosterone are 2–3 levels of magnitude (ng/mL) higher compared to circulation estrogen levels (pg/mL). Although a plethora of studies including observational studies, clinical trials, meta-analyses have demonstrated the importance of testosterone therapy in women with androgen deficiency, to date, there are no FDA approved testosterone formulations for women in the USA, and only off label utilization of testosterone by clinicians is currently practiced. The concerns regarding the efficacy and safety of testosterone therapy in women with sexual dysfunction have been appropriately addressed in randomized, placebo-controlled studies. Advances in this area will be gained when the clinical community, medical health care training systems, the pharmaceutical industry and the FDA become fully aware of this important health concern and begin to develop initiatives to address this critical aspect of women’s health. Despite considerable knowledge derived from research beginning in the 1940s establishing a physiological role for testosterone in women’s health and demonstrating substantial benefits of testosterone therapy in women with testosterone insufficiency, clinical use of testosterone in women is not well recognized as a therapeutic modality by the clinical community. This chapter highlight the advances made in this field.