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Context: In the 1990s, the American population-based study NHANES III renewed the focus on possible secular trends in male puberty. However, no conclusions could be made on pubertal onset due to the lack of compatible data.

Objective: The aim of the study was to evaluate secular trends in pubertal onset during the recent 15 yr and their relation to body mass index (BMI) in boys.

Design and Setting: We conducted a cross-sectional study in 1991–1993 and a combined cross-sectional and longitudinal study in 2006–2008 (The Copenhagen Puberty Study) at a tertiary center for pediatric endocrinology.

Participants: A total of 1528 boys aged 5.8 to 19.9 yr participated (n = 824 in 1991–1993, and n = 704 in 2006–2008). Genital and pubic hair stages as well as testicular volume by orchidometry were evaluated. Blood samples were analyzed for LH, FSH, testosterone, and …