The article investigates the prevalence of differences in sex development (DSD) among pediatric patients with both hypospadias and undescended testes (UDT). Topics include a higher incidence of DSD in patients with proximal hypospadias and non-palpable UDT, with mixed gonadal dysgenesis being the most common DSD type. The study underscores the importance of DSD evaluation in these cases to guide appropriate management.