Numerous highly effective topical vaginal antimycotic agents are available that provide high cure rates with a favorable therapeutic side effect ratio. Recently three oral systemic azole agents have been added. Therapeutic options afford the opportunity of customizing therapy to achieve optimal cure rates. At the same time, several new complex issues have appeared that constitute new challenges to successful management, such as women with human immunodeficiency virus infection and infection caused by non-albicans Candida species and resistant strains of Candida albicans.