A 14-year-old adolescent girl presented with primary amenorrhea and uncontrolled pelvic pain. Evaluation using pelvic sonogram, magnetic resonance imaging, and laparoscopy confirmed the diagnosis of cervicovaginal aplasia with functioning endometrium and a vaginal fistulous tract. At age 19 years, hysterectomy and vaginoplasty allowed the patient to be free of pain and to have normal sexual function.