Today, homosexuality has become a topic of discussion throughout the psychological community and society at large. However, there is great controversy about the etiology of homosexuality and more specifically, lesbianism. This paper describes a review of the literature to examine the hypothesis that a multitude of factors may influence the development of a lesbian sexual orientation. It examines whether lesbianism is the result of environmental influences or is secondary to biological factors. Studies to evaluate biological factors, which include maternal stress, genetic and hormonal factors, have not concurred about factors that can lead to an increase in the number of offspring with lesbian tendencies. Environmental predisposition towards lesbianism such as familial, sexual abuse, psychosocial, and developmental factors indicate that a combination of these factors may lead a woman towards development of a lesbian sexual orientation. The research concludes that multiple pathways may lead to a lesbian or heterosexual orientation, thereby allowing for the interplay of both biological and psychosocial factors. The paper concludes that it is imperative that the psychological community continues to research lesbian sexual orientation to make information available and accurate to help eliminate the myths, misconceptions, and prejudices regarding the origin of a lesbian sexual orientation. (Contains 50 references.) (JDM)