Introduction: Primary amenorrhea is defined as lack of attainment of menarche by the age of 15 years in a patient with appropriate development of secondary sexual characteristics and 13 years in the absence of secondary sexual characters. The present study is undertaken to study the etiological features, associated anomalies and treatment options for patients with primary amenorrhea. Objectives • To determine the incidence of etiological factors of primary amenorrhea. • To determine the association of various anomalies with primary amenorrhea. Methodology: It is a retrospective study planned to be conducted from Jan 2011 December 2015, in the Department of Obstetrics and Gynaecology, Vydehi Institute of Medical Sciences and Research Centre. Results: In our study group I, i.e., eugonadotrophic group consists of 34 patients (77.2%), group II, i.e., hypergonadotrophic group has 9 (20.45%) patients and 1 patient in hypergonadotrophic group, i.e. group I. In group I mean FSH, LH estradiol, prolactin and TSH values are 6.89 miu/mL, 8.8 miu/mL, 45 pg/mL, 20.8 ng/mL, and 3.05 iu/mL. In group II mean values of FSH, LH, estradiol, prolactin, and TSH are 51.82 miu/mL, 13.3 miu/mL, 12.7 pg/mL, 22.1 ng/ mL and 5.4 iu/mL. Conclusion: Primary amenorrhea is an extremely stressful situation for young girls and needs psychological counseling to prevent long term sequelae. The feeling of defeminization and underdevelopment of secondary sexual characters is the major concern in patient and attendees is the major concerns which has to be addressed with careful counseling.