Uterine cancer is the fourth most common cancer of women in the United States and the most common gynecological malignancy. It can be divided into two very different categories. The first is epithelial tumors of the endometrial lining and the second is mesenchymal tumors or sarcomas. The American Cancer Society estimates 40,100 new cases of uterine cancer with around 7470 related deaths for 2008. Uterine sarcomas comprise only 3-6% of these cases, but account for around 26% of the deaths. The first part of this chapter will exclusively be dedicated to the much more common endometrial cancer, with a brief section on uterine sarcomas to follow. Ovarian cancer is the most lethal gynecological malignancy. Several types of cancers arise from ovarian tissues. The most common and deadly is epithelial ovarian cancer. Other rare types include germ cell and stromal tumors. With surgery and chemotherapy these rare types generally have a much better prognosis than epithelial histologies. Worldwide, cervical cancer is the leading cause of death from gynecological cancers and ranks among the leaders in cancer mortality for women. Nearly half a million cases are diagnosed each year. Incidence rates in developing countries are much higher than in developed. In 2008, an estimated 11,070 new cases of cervical cancer will be diagnosed in the United States, with 3,870 deaths. The mean age of diagnosis in the United States for cervical cancer is 51.4 years. Patients diagnosed are evenly distributed between two age groups, 30-39 and 60-69, with a trend towards increasing stage with increasing age. Since cervical cancer progresses slowly from preinvasive cervical intraepithelial neoplasia (CIN) to invasive cancer, this may suggest that older women are not screened as regularly as the younger cohort. Additionally, there are disproportionately higher numbers of black and Hispanic women affected, most likely from their lack of exposure to appropriate resources. In developed countries, women who present with cervical cancer often have not had regular Papanicolaou (Pap) smears. Establishment of appropriate screening programs is therefore an important public health issue. For developing countries, women often present with advanced disease, which unfortunately may have already eroded into the bladder, rectum, pelvic nerves or bone. This often leads these women to becoming social outcasts and secondary to a lack of adequate treatment facilities, die alone, in severe pain, with foul smelling vaginal discharge. Vulvar cancer is the fourth most common gynecological cancer, comprising less than 5% of all cancers of the female genital tract. The American Cancer Society estimates 3,460 new cases of vulvar cancer with an associated 870 deaths for 2008. The most common cancer of the vulva is squamous cell carcinoma, accounting for over 90% of cases, while melanoma is the second most common. Other histologic types include adenocarcinomas, basal cell carcinomas and rarely sarcomas.