Primary carcinoma of the vulva is predominantly a disease of elderly women, a somewhat infrequent entity, accounting for approximately 3-4% of all female genital cancer and less than 1% of all malignant disease. Many studies have pointed out the long delay in the diagnosis of the cancer. This is due not only to the reluctance of the older patient to seek attention for this "personal problem", but to the delay of the physician in taking a biopsy. Therefore physicians should carry out a biopsy in every patient when the diagnosis is uncertain or the lesion fails to resolve with topical therapy. We experienced a case of squamous cell carcinoma arising from the clitoris in 65 years old woman. She had had a pruritic erythematous patch on the external genitals for 20 years but never visited a clinic. One month before, she found a reddish papule on the clitoris which enlarged rapidly and reached a exophytic hard 1.5 * 2.1 cm sized mass. The patient was treated with a radical vulvectomy and bilateral lymph nodes dissection of the groin with oophorectomy. She had been followed for 20 months without any evidence of recurrence. (Kor J Dermatol 1996;34(1): 171-175)