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Aim: To verify possible associations among glucocorticoid doses, use of dexamethasone, and bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA) and quantitative computed tomography (QCT), in female children with congenital adrenal hyperplasia due to CYP21 deficiency (CAH-CYP21). Classical CAH-CYP21 in females allows the study of the effects of hyperandrogenism and chronic glucocorticoid exposure. Design: Cross-sectional observational study. Patients: Sixteen girls (4-19 years) with CAH-CYP21 and 32 age-matched control girls. Measurements: BMD was the main outcome measure assessed by total body and lumbar spine L 1 -L 4 DXA (DXA tot and DXA ls ), lumbar spine L 1 -L 4 bone mineral apparent density (BMAD) and spinal L 1 -L 4 QCT of trabecular (QCT trab ) and cortical (QCT cort ) bone. The glucocorticoid dose used by patients with CAH-CYP21 was expressed as hydrocortisone equivalents/m 2 . Results: Mean BMD in both groups was similar by any method. In patients, BMD decreased with the increasing mean dose of glucocorticoid, seen in QCT cort (r = -0.55; p = 0.03) and QCT trab (r = -0.52; p = 0.04). There was also a negative correlation between cumulative glucocorticoid dose and BMD in QCT cort (β = -0.0016; p = 0.005) and QCT trab (β = -0.0009; p = 0.03). Conclusions: The dose of glucocorticoid used in the treatment of girls with CAH-CYP21 correlated negatively with BMD, and dexamethasone was not selectively harmful.