The Vecchietti method is a surgical technique for the treatment of vaginal agenesis that constructs a dilation-type neovagina in 7–9 days. We have performed the Vecchietti operation on six patients. The method was applied to create a primary neovagina, to lengthen a surgically foreshortened vagina, and to reconstruct an obliterated neovagina with or without the presence of a uterus. Two patients underwent the conventional transabdominal approach, and four, laparoscopy. Follow-up was 7-39 months, and neovaginal depth was 8.0–10.6 cm. The anatomic and functional results in all patients were excellent.