Genital amebiasis by Entamoeba histolytica is rare, even in Mexico where the disease is endemic. We report a case of genital amebiasis in a female patient with a recto-perineal fistula and two-week history of a profuse vaginal discharge, a painful and friable vulvar ulcer and induration in gluteal and inner side of thighs. The PAP smear and the biopsy showed trophozoites, no malignant cells were observed. The findings were compatible with genital amebiasis. The serology test for E. histolytica was positive (> 1: 512). The patient was treated with metronidazol 750 mg tid for 3 weeks. Complete resolution was achieved. The long term fistula, the low socioeconomic status, the poor hygiene and diabetes mellitus of a recent onset were probably the risk factors associated to this infection. We reviewed the literature.