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Objective. To analyze the delay of puberty of central genesis in adolescent girls as a complex medical and social problem, in particular the role of neuroendocrine mechanisms, psychosocial and organizational factors in its formation, as well as to summarize modern scientific and normative approaches to diagnosis, medical support and the organization of specialized assistance in the health care system. Methods. A systematic literature review was conducted for the period 2019–2024 using PubMed, Scopus, Web of Science, MEDLINE, Cochrane Library, and Google Scholar databases. The review included more than 34 publications, including original clinical trials, systematic reviews, meta-analyses, as well as official clinical protocols, professional medical society guidelines, and public health regulatory documents that address the etiology, pathogenesis, clinical manifestations, and organizational aspects of the care of adolescent girls with central genesis of puberty. The synthesis of the results was carried out by means of a narrative analysis with a generalization of the medical and socio-organizational determinants of the problem. Results. A systematic review of 34 publications showed that central puberty delay in adolescent girls is multifactorial in nature. The main ones are functional disorders of the hypothalamic-pituitary axis caused by psychosocial stress, energy deficit and high physical exertion (60% of cases). Organic, genetic, and extragenital factors occur less often (15–10%). Pathology is clinically manifested by delayed thelarche, primary amenorrhea, and a decrease in LH, FSH, and estradiol levels. Psychosocial and organizational factors influence the timeliness of diagnosis. Early screening assessment and multidisciplinary approach improve treatment outcomes and reduce the risk of secondary complications. Conclusions. Central puberty delay in adolescent girls is a complex medical and social problem that requires interdisciplinary management. The main factors are psychosocial stress, energy deficit and physical overload. Early diagnosis, standardized protocols and comprehensive management increase the likelihood of normalization of pubertal development and reduce the risk of complications.