Six cases of primary advanced squamous carcinoma of the vulva were treated with concomitant chemotherapy and radiotherapy (C + RT). In five patients it was given in preparation for surgery. The radiation was delivered to the whole pelvis in 10 equal daily fractions of either 2.0 or 2.5 Gy. Mitomycin C (10 mg/m2) was given on Day 1, and 5-fluorouracil (1000 mg/m2) was given daily from Days 1 to 4, inclusive. All six patients had satisfactory early tumor response. Three patients received one course of C + RT and three were given two courses. One patient died suddenly of unknown causes 6 days after completing the C + RT. One patient with fixed groin nodes was treated with palliative intent. She maintained a complete local response but died 6 months later of liver metastases. The remaining four patients underwent surgery without healing complications and are alive with no evidence of disease at 1, 4, 14, and 26 months. In our experience vulval carcinomas can be reduced in size and extent by prior chemotherapy and radiotherapy and require less extensive surgery.