Cancers of the cervix, vulva, and vagina represent the major malignancies of the lower female genital tract. With the exception of the endocervix, this portion of the genital tract is available for physical examination, including direct visual inspection and palpation. Currently, cytologic screening and surveillance by Papanicolaou (Pap) smear, testing for the presence of oncogenic strains of the human papillomavirus (HPV), colposcopy, and a variety of confirmatory biopsy techniques are capable of diagnosing preinvasive disease or very early-stage invasive disease that can be treated with a high probability of cure. Improvements in diagnostic imaging and assessment of disease extent before therapeutic intervention and more routine use of integrated, multimodality therapy together offer the opportunity for better outcomes for women with invasive local or regional disease.