Vulvar cancer is relatively uncommon, accounting for 3–5% of all gynecological cancers and 1% of all cancers in women with an incidence rate of 1-2/100,000 women. Combined modality treatment by surgery, chemotherapy and radiation therapy has become an established approach for advanced vulvar cancer. The aim of this approach is to reduce the treatment related complications without compromising survival. Although acute toxicity, especially moist desquamation occurs in almost all cases, treatment is well tolerated even by elderly population. The role of preoperative chemoradiation in less advanced disease needs further evaluation as discussed. Adjuvant radiation with or without concurrent chemotherapy is an important strategy to reduce recurrence rates and improve overall survival in high risk patients with metastatic groin nodes. The role of newer chemotherapeutic agents and newer radiation techniques like intensity modulated radiation therapy is discussed.