Vulvodynia is a complex disorder and described as discomfort or intense burning pain in the vulvar area. Such chronic pain affects 5 to 15% of women and many suffer of misdiagnosis. For sure the aetiology is multifactorial. Through few studies we consider the inflammatory response plays a major role. There is a genetic profile of women suffering of vulvodynia, especially genetic polymorphisms from genes coding for cytokines, Interleukin-1 receptor antagonist and Interleukin-1 beta, and gene coding for mannose-binding lectin (MBL). These polymorphisms result in a stronger inflammatory response and lay these women in a susceptibility situation. Histological analysis showed a chronic no specific inflammation. We have also demonstrated that these patients present in normal state or under infectious induction an inadequate inflammatory response. But there is still a variety of mechanisms which can interact with the inflammatory response. Management of such vulvar pain syndrome could be very frustrating, but the first step for improvement is to get the right diagnosis.