No associated or etiological factors could be identified in 35 malignancies of the vagina presented. Abnormal vaginal bleeding and an atypical discharge were the usual presenting symptoms in three quarters of the patients. The treatment either by surgery or irradiation in the early-stage lesion gave excellent survivals. In latestage lesions, survival was poor in that of five patients treated with ultraradical surgery, all died, and of 11 patients treated with radiation, only two lived over five years without recurrence. Irradiation, however, preserves a functional bladder, vagina, and rectum. A program integrating external irradiation with radium plus patient individualization is presented as a treatment of choice for most vaginal malignancies.