Vulvodynia represents an important, but poorly understood collection of health issues affecting 1 in 8 women. Pain and discomfort interfere with normal daily activities such as sitting, exercising and sexual intimacy. The intensely personal nature of these disorders results in feelings of isolation and anxiety for many affected women. Since a variety of benign disorders of the vulva and vagina can contribute to the development and/or maintenance of vulvar pain, clinicians caring for women with vulvodynia must understand the impact and inter-relationships of these conditions. This paper reviews the current classifications and primary causes of vulvodynia. The primary anatomic, dermatologic, myofascial, infectious, neuropathic, and psychosexual factors contributing to vulvar pain are presented, along with evidence-based guidelines to the treatment.