Premature pubarche can be benign, or it can be an early marker of insulin resistance in some girls. The aim of this study was to evaluate insulin resistance in prepubertal girls presenting with premature pubarche (n = 19; mean age = 6.93 +/- 1.78) as compared to age- and Tanner stage-matched controls (n = 10; mean age = 7.55 +/- 1.32) using indirect insulin resistance parameters. Two groups were compared by means of oral glucose tolerance test (OGTT), indirect insulin resistance (IR) parameters [homeostasis assessment (HOMA) models: HOMA-IR, glucose/insulin (G/I)] and serum lipid profiles. In the girls with premature pubarche, mean baseline insulin level and HOMA-IR value were significantly higher and G/I ratio was lower than in the control group. IR was observed in 42.1% and in 31.6% according to HOMA-IR value and G/I ratio, respectively. Even at diagnosis, IR was increased in a significant portion of the girls with premature pubarche.