Hermaphroditism or intersex disorders, now collectively known as disorders of sexual differentiation, represent a group of congenital anomalies of genotypic and phenotypic expression requiring complex management strategies which vary across the world. Management protocols involve multiple surgeries along with hormonal supplementations and a strict long-term follow-up schedule till the child reaches adulthood. Rarity of disease and multimodality treatment attract controversies in the management. In this chapter, we have tried to elaborate on the gonadal development, classification of DSD, recent management protocols including surgical techniques of genital reconstructions.