To describe and estimate both short-term and long-term effectiveness of a large cohort of women treated with modified vestibulectomy in a single surgical service.A total of 202 patients who were treated with modified vestibulectomy for localized provoked vestibulodynia at Mayo Clinic in Rochester, Minnesota, were mailed a questionnaire to document severity of vulvar pain or discomfort before and after the surgery.In total, 115 patients returned the questionnaire. Of the 71 patients who before surgery reported pain when inserting a tampon, 52 reported attempting to insert a tampon after surgery. Of these 52 patients, 47 (90.4%) noticed moderate to substantial improvement. Pain with sexual intercourse occurred in 97.3% (107/ 110) of patients before surgery. After surgery, 90 (84.1%) of those 107 patients noted moderate to substantial improvement in their pain with intercourse.Modified vestibulectomy was a successful treatment for patients with localized provoked vestibulodynia and resulted in strong patient satisfaction, long-term effectiveness, minimal scarring, and few postoperative complications.