Management of disorders of sexual development (DSD) partly remains controversial: initial clinical management, timing of surgical interventions and its applied techniques are a matter of debate. The present review describes the current management of the different groups of DSD. It underlines the significance of the neonatal period, both for the child as for the parents, when support is of outmost importance. As soon as possible and in a sensitive manner, a Relationship of trust must be established, later on passing information also to the child, adapted to his/her age. The management has to be discussed in and offered by a multidisciplinary team, ideally in a transdisciplinary way, and must be provided in a reference center. Long term follow-up until adulthood and beyond is mandatory. Surgical indications and techniques are discussed based on the state of the art. The importance of dedicated, specialized surgical teams is highlighted, allowing for expertise, hence obtaining a significant reduction of post-operative complications, as underlined by recent research. The discussion ends with some perspectives for the French-speaking Western part of Switzerland, this particularly in conjunction with the development of the University Center of Pediatric Surgery of Western Switzerland, implying centralisation of complex urological cases, DSD patients obviously being part of it.