Less extensive surgical treatment has become possible for limited vulvar cancer. However, primary closure is advisable only when the defect is minimal and tissue replacement is always needed in radical excisions. Local flaps are always considered the first choice because of their characteristics of similarity to the resected area. The V-Y island flaps from the medial side of thigh constitute one of the numerous options. Clinical experience and anatomical studies demonstrate that this procedure is extremely safe thanks to the rich subcutaneous vascular network. After illustrating the theoretical bases and the indications of this surgical procedure, we report our experience. The V-Y technique is reliable, ensures good healing, and provides almost normal sensation. We conclude that, in most instances, it can be considered a good option for vulvar reconstruction for its versatility and rapidity of execution.