We retrospectively reviewed the cases of carcinoma in situ of the vulva seen at the State University of New York at Buffalo affiliated hospitals. The frequency of carcinoma in situ of the vulva is increasing among the younger population. There is a close relationship with sexually transmitted diseases and other genital and extragenital premalignant and malignant conditions, infections, immunosuppression, previous pelvic radiation, possible synergetic action of herpes simplex type 2 and human papilloma virus. In his study we tried to compare the results of different modes of therapies. This is an updated version of the publication of Buffalo Oncology Group about this subject (Obstetrics and Gynecology; 64:4, 1986 pp 504-507).