From 1978 to 1991, 69 cases of primary carcinoma of the vulva were diagnosed and treated at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. The average age was 56 years at the time of diagnosis. Five patients (7.2%) were in FIGO Stage I, 25 (36.2%) Stage II, 28 (40.6%) Stage III and 11 (15.9%) Stage IV. Histologically, 60 cases were squamous cell carcinoma, large cell non-keratinizing type, 2 (2.9%) of squamous cell carcinoma, large cell keratinizing type, 2 (2.9%) of adenocarcinoma, 1 (1.4%) of basal cell carcinoma and 1 (1.4%) of malignant melanoma. Radical vulvectomy with inguino-femoral lymphadenectomy were performed in 42 patients. The rest were rejected or unsuitable for surgery. The actuarial 5 and 10-year survival rate for 61 patients followed up 1 to 14 years was 66.0%. The 5-year survival rate for operable cases was 88.5% but for unoperable cases it was only 22.0%. The authors still confirm surgery as the primary treatment of choice for this rare malignancy.