In the last decades there is a shifting paradigm in the understanding of intersex conditions with regards to the gender assignment and the choice of the surgical technique for genitoplasty. The cosmetic and functional results of masculinizing genitoplasty are rarely assessed in the literature. We reviewed the medical literature regarding primary diagnosis, gender assignment, preoperative evaluation, goals of surgical correction, timing of surgery and surgical technique. We critically reviewed our technique of masculinizing genitoplasty in 55 patients. In conclusion, we believe that this masculinizing genitoplasty is a feasible procedure in most of the patients with ambiguous genitalia raised as males with satisfactory functional and cosmetic results.