Introduction: Early puberty is suspected to be promoted by exposure to endocrine disruptors (EDs), and its incidence has been identified by an international panel of scientists as a key indicator to monitor. It is characterized by signs of puberty before the age of eight in girls and nine in boys. Girls are affected 10 times more often than boys. The most common form is idiopathic central precocious puberty (ICPP), and its treatment is specific, involving GnRH agonists. The objective was to estimate, for the first time, the incidence of ICPP in metropolitan France and to analyze its geographic trends.Methods: An indicator reflecting incident cases of children treated with GnRH agonists was constructed using Sniiram data for the 2011–2013 period. Four predictive spatial models were tested to analyze spatial trends and estimate incidence rates.Results: The national incidence rate was 2.68 [95% CI: 2.55–2.81] per 10,000 girls (1,173 new cases/year) and 0.24 [0.21–0.27] per 10,000 boys (117 new cases/year). Among both girls and boys, a structured spatial heterogeneity was observed (incidence differences ranging from 1 to 12 among girls), geographically consistent, with marked excess incidence in the Midi-Pyrénées and Rhône-Alpes regions.Conclusions: Incidence estimates for PPCI in France are comparable to those from other studies abroad. The observed spatial heterogeneity suggests that environmental risk factors exist that warrant further investigation.