Radical vulvectomy is the accepted treatment for carcinoma of the vulva. The operative mortality is now very low and the 5 year survival rate of over 66 per cent is encouraging. The technique here described is based on a series of 125 cases. Emphasis is placed on the method of inguinal lymphadenectomy and also on the technique of transposing the urethral orifice to prevent stress incontinence. Residual disability is surprisingly small and vaginal delivery has been possible subsequently. © 1968.