AbstractIntroductionVan Wyc Grumbach syndrome is a rare presentation of long standing pre-pubertal hypothyroidism characterized by bilateral multicystic ovaries, vaginal bleeding and delayed skeletal growth in case of female. Laboratory investigation reveals very high levels of thyroid stimulating hormone and there is presence of delayed bone growth. Case reportHere, we present a clinical course, diagnosis and management of a case of Van Wyc Grumbach syndrome in a 5 year Nepalese female child who otherwise would have undergone surgical intervention if timely thyroid function test was not done. ConclusionIt is important to recognize this syndrome because prompt initiation of easily available thyroid hormone therapy can completely resolve symptoms, avoiding unnecessary investigations and interventions.