The vestibule, or introitus, is a unique area in the lower genital canal. Of major importance is the understanding of the embryology of the area if the lesions are to be interpreted adequately. It is a "collision zone" formed at the junction of different germ layers. The newly recognized syndrome of severe dyspareunia caused by inflammation of the minor vestibular glands affects many women. At present, ablative therapy is all that can be offered to these patients. While excisional surgery is highly successful, medical therapy awaits the elucidation of the true cause of this disorder. Vestibular mucous cysts and vestibular papillae are common benign conditions which must be recognized as such, lest inappropriate therapy be recommended.