During the interval 1962 through 1982, ten patients, having a mean age of 49.5 years, were treated for primary carcinoma of the Bartholin gland at the Medical College of Virginia. In all cases, a primary surgical therapeutic approach was selected, which included radical vulvectomy with bilateral inguinal-femoral node dissection in nine cases. Of the patients followed from eight months to 9.5 years, 50% are alive and well without evidence of recurrent disease. Histologic assessment of lymph nodes demonstrated metastatic involvement in five of nine cases (55%) with four of five patients dead of their disease. The most common histologic pattern was squamous cell carcinoma. The most common presenting complaint was a painless mass. Radical surgery is appropriate as standard primary therapy, whereas the role of radiation appears less clear.