There are a number of conditions affecting the vagina and vulva that can be optimally assessed with the use of high-resolution magnetic resonance imaging (MRI). This paper gives a suggested protocol for MRI technique and sequences for imaging the pelvis and perineum and reviews the MRI appearances of many of the common pathologies affecting the vagina and vulva. Congenital anomalies, inflammatory and neoplastic entities such as vaginal and vulval carcinoma are discussed, with rarer malignancies also reviewed.