Differences in biological behaviour make familiarity with (and accurate diagnosis of) vulvovaginal soft tissue tumours essential. Since ancillary studies such as immunoperoxidase staining and electron microscopy may not always be helpful in their distinction, one must often rely on morphological features to distinguish between different tumour types. This is particularly pertinent with regard to the relatively site-specific stromal tumours of this region. The purpose of this review article is to reacquaint the reader with these specific types of vulvovaginal soft tissue tumour, particularly focusing upon the salient morphological features that help in their distinction, as well as to review their clinical aspects and pathogenesis. The following soft tissue lesions are described: fibroepithelial stromal polyp, cellular angiofibroma, angiomyofibroblastoma, superficial angiomyxoma and aggressive angiomyxoma. Because of continued difficulty in predicting their behaviour, a discussion of vulvar smooth muscle tumours is also included, with a particular focus upon a practical approach to their diagnosis.