Both vulvar and vaginal carcinomas are rare malignancies in women. However, within the past decade a distinct increase in the incidence of vulvar intraepithelial neoplasia (VIN) as a precursor lesion, and an increase of vulvar cancer have been reported within Europe and the U.S. The most important factor in developing vulvar cancer is human papillomavirus (HPV) infections but prophylactic HPV vaccination has been proven to be highly effective. Surgery is the first choice in treating patients with vulvovaginal carcinoma, especially in the early stages. The operative treatment options depend on the localization and spread of the tumor. In an attempt to decrease the incidence of complications, research was made into surgical modifications without compromising the prognosis. For the treatment of vaginal cancer no approaches for reducing the degree of radical surgery are known. Radiation treatment remains a therapy option in advanced disease. As vulvovaginal cancer is relatively rare it is possible to give evidence-based treatment recommendations but usually on a low evidence level.