A recent reassessment of the combined experience in treating vulvar cancer at the Pondville State Cancer Hospital and the Massachusetts General Hospital has been undertaken, covering the 25 years that have elapsed since an earlier comprehensive review was carried out. A few differences in some of the clinical features of the disease and the manner in which it presents itself today were observed. Basic principles of management that had emerged at the time of the earlier report have remained fundamentally the same. However, as the result of a recent trend toward earlier diagnosis that permits prompt treatment of smaller lesions with a lower potential for having had lymphatic spread at the time they are dealt with, there is now room for a somewhat greater degree of careful individualization of the basic surgical approach. This philosophy has been reflected in certain modifications of the overall plan of management as well as in improvements in the technical aspects of diagnosis and therapy that have reduced complications and increased salvage.