The age of female puberty appears to have decreased in the United States and western countries as child health and nutrition have improved and obesity has become more prevalent. Also, environmental contaminants, particularly endocrine disruptors, may also play a role in lowering the age of puberty. Puberty at an early age increases the risk of stress, poor school performance, teen pregnancy, eating disorders, substance abuse, and a variety of health issues which may appear later in life including breast cancer and heart disease. Articles for this literature review were located using a computerized search of the databases Health Reference Center, Medline, PsycINFO, and ScienceDirect from 2000 to 2008. Also, reference lists from key published research were reviewed for relevant publications. Risk factors related to early puberty include genetics, race, maternal weight gain, premature or low birth weight, fatherlessness, environmental contaminants, obesity, and race. Maintenance or achievement of healthy weight, regular exercise, and a fiber-rich diet may delay the onset of early puberty. As the number of girls entering premature puberty increases, there are numerous risks, both physical and emotional. Health educators need to explore ways to help reduce the incidence and prevalence of obesity and address other modifiable risk factors.