A case of primary hypertrophic tuberculosis of the vulva is descriptionbed, which was treated with streptomycin. Several interesting features of tuberculosis of the vulva were illustrated by this case: The overwhelming majority of cases of tuberculosis of the vulva are secondary to a focus elsewhere, particularly the upper genital tract, the lungs, the urinary or gastro-intestinal tracts. It has been reported following tuberculous epididymitis in the male partner. Extensive search revealed none of these sources and the case must be regarded as a true example of primary tubercular disease of the vulva. This is so rare that some authors even deny its occurrence as such. Two varieties of vulval tuberculosis are generally recognized, the ulcerative and the hypertrophic type. The ulcerative lesion is about 10 times more common than the latter. This case was, in addition, the less common variety of the disease. The most interesting feature of the case is its remarkable response to streptomycin. This is the first case to be recorded of tuberculosis of the vulva treated in this way. The encouraging response suggests that this may probably be the best form of treatment. It is hoped that further cases of this uncommon lesion will be given a trial of streptomycin therapy and the results published.