Although the local and regional radicality in treating vulvar carcinoma could be reduced during the last years, the inguinal lymphadenectomy with its short term and long term morbidity will remain in most cases a necessary part of the surgical treatment. Therefore, since some years, there are studies to find out whether the procedure of sentinel lymph node biopsy could be used in vulvar cancer. The results up to now show an almost hundred percent rate for identification of the sentinel node using radioactive tracer alone or in combination with vital dye. Histological diagnosis of metastases in a sentinel node yields very high values for sensitivity and specificity. The sentinel lymph node procedure in vulvar cancer, however, is not sufficiently evaluated up to now to replace the standard of complete inguinal lymphadenectomy.