The treatment of cryptorchidism has come full circle over the past century, beginning with surgery advocated in older boys, then following with hormonal therapy as primary treatment. Today surgery is advocated in early infancy with or without adjuvant hormonal therapy. Our better understanding of the hypothalamic-pituitary-gonadal axis and histology of the developing testis has added greatly to our knowledge, significantly influencing our management of the cryptorchid testis. The aims of orchiopexy are to improve fertility, decrease malignancy potential, and minimize psychological stress associated with an empty scrotum. Surgery may or may not achieve these goals alone. The addition of hormonal therapy to orchiopexy may prove beneficial to achieve all these objectives.