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Background  Further knowledge about the pubertal development mode of girls with Turner syndrome (TS) who have undergone hormone replacement therapy (HRT) is beneficial to the proposal of an optimal HRT regimen. This study examined the pubertal development mode of girls with TS who underwent HRT and evaluated the characteristics of optimal sex induction therapy in girls with TS.    Method  We conducted a retrospective, longitudinal study over the past two decades at The First Affiliated Hospital, Sun Yat-sen University.    Patients  Seventy-one patients with TS and two groups of normal Chinese girls.    Results  The total investigation time was 3.00 (2.00, 4.66) years. The interval of each stage was significantly longer ( P  < 0.001) in the girls with TS than that in the normal Chinese girls, except for B2–3 ( P  = 0.011). The uterine volumes of the girls with TS in stages B2 and 3 were greater than those of the control group ( P  = 0.046), whereas the uterine volume of the control group was inversely greater than that of the TS group among those who reached stages B4 and 5 ( P  = 0.034). During HRT, the uterine volume grew significantly from all previous stages except for breast stage 5 (B 3 vs.2 : Z = − 2.031;  P  = 0.042; B 4 vs. 3 : Z = − 2.273;  P  = 0.023; B 5 vs. 4 : Z = − 1.368;  P  = 0.171). The paired data of 27 girls with TS showed that the uterine volume (17.93 ± 9.31 ml vs. 13.75 ± 6.67 ml) and width (2.54 ± 0.66 cm vs. 2.22 ± 0.36 cm) increased significantly during artificial cycles compared with before artificial cycles (t = − 2.79 and − 2.51,  P  = 0.01 and 0.018).    Conclusion  HRT led to normal breast development in girls with TS; half of the girls with TS in our study reached Tanner stage B5, although the uterus ultimately developed suboptimally. The girls’ breasts and uteruses grew quickly at the beginning of HRT (stages B2–4). An optimal HRT regimen for girls with TS may specifically focus on Tanner stages B2–4 and artificial cycles.

The pubertal development mode of Chinese girls with turner syndrome undergoing hormone replacement therapy