Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) occurs due to the absence of the development of the Mullerian (paramesonephric) system. The etiology or cause of the disease is unknown. It is characterized by the absence of the uterus and upper-two thirds of the vagina with normal ovaries. The vagina is blind-ending and shortened. Patients usually present with painless primary amenorrhea with normal secondary sexual characteristics. Diagnosis is confirmed by ultrasound which shows normal ovaries but no uterus. Treatment options include surgical creation (elongation) of the vagina and psychological support.