Pubertal gynecomastia (PG) refers to the abnormal development and hyperplasia of unilateral or bilateral breast tissue in adolescent males, a common condition with a prevalence of up to 50% among appropriately aged adolescents, and an increasing incidence trend over the years. The etiology of PG is multifactorial, including physiological, pharmacological, and pathological causes. Endocrine hormones play a crucial role in the pathogenesis of PG across different etiologies. This review provides a detailed discussion on the effects of various endocrine hormones, including FSH, LH, T, E2, PRL, GH, and thyroid hormones, on pubertal gynecomastia in adolescent males, aiming to offer valuable insights for clinical diagnosis and treatment.