This chapter presents etiology, symptoms, diagnostic difficulties, and the treatment of vaginitis. Inflammation of the vagina is the most common gynecological problem encountered by primary care physicians. The symptoms of vaginitis may include itching, irritation, purulent or other discharge, and foul odor. Bacterial vaginosis (BV) is the most common cause of vaginitis in the USA. During pregnancy, trichomoniasis is sometimes associated with preterm labor and premature rupture of membranes. Over-the-telephone diagnosis of vaginal infection is difficult and often wrong. Men physicians are more likely to treat vaginal infections over the phone than women physicians who usually require an office visit. Treatment for BV includes a variety of oral and topical treatments. Complementary treatment for single episodes and recurrent vaginitis are common. Treatment of recurrent BV may be achieved by twice-weekly treatment with metronidazole topical gel, although secondary infection with Candida can occur.