Vaginal and vulvar issues related to abnormalities of dermatologic and anatomic origin can be neoplastic or nonneoplastic. There are numerous conditions that affect the health and well-being of the vulva and vagina. It is important to first consider anatomic and embryologic development because it can lead to a more intuitive understanding of disease. Embryologic development of the vagina provides an explanation for the variety of septa that can occur. Anatomic variation becomes more intuitive when developmental processes are also understood, especially in the case of paramesonephric defects of the fallopian tubes, uterus, and vagina. Vaginal development progresses from both endoderm and ectoderm. The vascular supply to the lower genital tract is similar in anatomy to the nervous supply; hematologic and nervous supplies are tethered throughout the body as neurovascular bundles. The prevalence of vulvar disorders favors the postmenopausal patient population; however, they can be present at any age.