Surgical treatment still remains the cornerstone of treatment of vulvar cancer. Several large-scale studies indicate that prognosis in vulvar cancer patients depends on depth of infiltration and invasion of regional inguinal-femoral lymph nodes. Due to considerable radicality of surgical procedures in vulvar cancer, women undergoing such procedures experience early and delayed complications, resulting in prolonged hospital stay and psychosexual alterations, stemming from the sense of mutilation. For the past few years, we are witnessing attempts at limiting the extent of surgical resection. Introduction of the concept of sentinel node in the treatment of vulvar cancer to oncologic gynecology will hopefully contribute to reduction of extent of surgical procedures in the future, i.e. refrain from inguinal-femoral lymphadenectomy, as metastatic lesions are not universally present in this part of the lymphatic system. The paper presents techniques enabling identification of a sentinel node. Based on quoted papers reporting on two multicenter studies encompassing patients with vulvar cancer, in a selected group of patients with negative sentinel node, departure from inguinal-femoral lymphadenectomy is justified. Contrariwise, detection of tumor cells in sentinel nodes warrants radical excision of regional inguinal-femoral lymphatic system, independent of the size of metastatic lesions (micro- or macroscopic). To date, departure from inguinal-femoral lymphadenectomy in vulvar cancer is permissible only if stromal invasion does not exceed 1 mm and tumor diameter is less than 2 cm (FIGO IA1, T1AN0M0).