Vulvar cancer is a rare gynecologic malignancy whose primary treatment is surgical. It is not uncommon for patients to delay seeking medical attention or for physicians to delay diagnosing the condition. The most prevalent vulvar cancer is squamous cell carcinoma, with vulvar melanoma being the second most common. The basic understanding of the anatomy and the mechanisms of lymphatic spread have made modifications in surgical technique possible, allowing less radical excisions with significantly less morbidity. New approaches using lymphatic mapping with sentinel node dissection appear promising for the future treatment of early vulvar cancers.