Data are presented from 97 patients treated for invasive primary epithelial carcinoma of the vagina between 1950 and 1980. The disease is primarily one of the elderly as 63% were found to be older than 60 years of age. Eleven of the 97 patients either refused or were unable to complete treatment because of poor medical condition or advanced stage of disease. Combined external and intracavitary radiation was the most common form of treatment. The overall two-year survival rate was 47%, or 59% when corrected for deaths due to other causes. Patients with stages I and II disease had corrected survival rates of 75% and 68%, respectively. Our results indicate that stage of disease is the most significant prognostic factor. Optimal results will be obtained with early diagnosis and individualized treatment.