Angiokeratomas are benign, vascular lesions that are very rarely identified in the vagina. A patient originally presented with endometrial cancer in 1993 and was cured following surgery and adjuvant radiotherapy. However, in 2007, she developed multiple, erythematous, vaginal nodules that were eventually diagnosed as angiokeratoma of the vagina. The diagnosis of vaginal angiokeratoma may not be initially suspected. Therefore, physicians should perform a histologic examination to verify the condition and accordingly, provide relevant clinical management.