Vulval cancer is rare and constitutes approximately 3% of gynaecological cancers worldwide. The incidence of vulval cancer has increased since the mid-1990s owing to the increased incidence in younger women, which has doubled over the past 30 years. Clinical trials in vulval cancer can be divided into two categories-trials in women with vulval cancer and, more recently, trials on the prevention of vulval cancer by preventing or treating human papillomavirus (HPV)-related vulval intraepithelial neoplasia (VIN). Numerous studies have tried to evaluate the role of neoadjuvant radiotherapy and/or chemotherapy in this disease to reduce the extent of surgery. Early studies involving the medical treatment of VIN with imiquimod, cidofovir and especially therapeutic vaccines appear promising in the prevention of vulval cancer. However, the greatest effect on preventing cancer is likely to arise as a result of vaccination programmes of the prophylactic HPV vaccines, assuming adequate uptake of the vaccine.