The purpose of this study was to compare levels of inflammatory cytokines, namely TNF- alpha, IL-1 beta, and IL-1 receptor in women with vulvar vestibulitis syndrome (VVS) relative to levels in controls. The authors hypothesized that tissue concentrations of inflammatory cytokines would be elevated significantly in women with VVB compared to pain-free controls. The study population consisted of 15 women with strictly defined VVB in reproductive age and 13 age-matched women with no history of vulvodynia. For TNF-alpha, positive staining was observed in 40% of the samples from the study group and in 7.7% of the samples from the control group. The difference between the groups was statistically significant (p < 0.05). In conclusion, a limitation of the present study was the relatively small sample size. However, the authors' intention was simply to propose that the local inflammation may be mediated by cytokines as TNF-alpha may rather than trying to single out a pathogenesis of VVS. The authors' findings of elevated TNF-alpha may suggest new therapeutic alternatives for VVS, as inhibiting cytokine synthesis or antagonism of the cytokine receptor.