A clinical and histopathologic study of material from a series of 17 patients with basal cell carcinoma of the vulva are reviewed. The tumors occurred primarily in elderly patients (average age, 59 years), the majority of whom were Caucasian. Presenting symptomatology consisted primarily of pruritis vulvae and/or the presence of a vulvar mass (79%) of long duration (average, 6 years, 7 months). The lesions were described grossly as ulcerations or masses located on the anterior Iabium majus. Etiologies were indeterminate although 2 patients had previously received vulvar irradiation. Therapy consisted primarily of wide local excision and was effective in that follow-up studies in 16 patients revealed no deaths attributable to basal cell carcinoma. These data indicate that basal cell carcinoma is a locally invasive nonmetastasizing tumor best treated by wide local excision providing the tumor edge does not extend to the margin of excision.