Vaginal agenesis in association with a functional uterus occurs infrequently, and usually presents in adolescents. To preserve reproductive function, the uterus must be conserved, and a vagina must be constructed in one operative procedure. The authors describe a surgical technique that combines a modified Mclndoe vaginoplasty with uterine conservation in which a special stent is fabricated to insert in the uterine cervix and the neovagina. Factors that must be considered when choosing between a hysterectomy and a uterine conservation procedure also are discussed.