Abstract Vaginal cancer may not be as uncommon or have as poor a prognosis as was formerly believed. In this series of 101 patients, which included 70 with invasive and 31 with in situ lesions, intravaginal radium, either alone or in combination with external irradiation, was the principal form of therapy. Results show that aggressive treatment is worthwhile in early or moderately advanced disease. The preferred treatment is still unclear, however, and can only be determined by combined experience. Observations are also presented on 23 patients with in situ-like changes developing after radio-therapy for cervical carcinoma. Such changes may or may not represent cancer.