Abstract: Vulvar squamous cell carcinoma (VSCC) is a rare but gradually increasing cancer of the female reproductive system, characterized by a high recurrence rate and poor prognosis. In recent years, significant progress has been made in understanding the etiology, diagnosis, and treatment of VSCC. The classification criteria for VSCC have gradually shifted from histological to molecular levels associated with HPV and P53 protein. More importantly, different molecular subtypes have been proven to exhibit distinct genomic mutations and clinical prognoses. Consequently, the molecular subtypes of VSCC are expected to guide the selection of targeted therapies, immunotherapies, and surgical strategies. Simultaneously, the evolution of inguinal lymph node management from traditional surgery to individualized surgical strategies, along with new treatment methods, including electrochemotherapy, targeted therapy, and immunotherapy, has provided more options for the clinical management of VSCC. This review integrates the literature from the past five years to elucidate the latest viewpoints and technologies in the clinical diagnosis and treatment of VSCC, aiming to provide clinicians with a comprehensive perspective to promote a deeper understanding of and management of VSCC.