Lower genital tract malignancy during pregnancy is rare. Due to the rarity of this condition, the best evidence in its management is based on case reports. The management of the lower genital tract malignancy is influenced by factors including oncological factors, maternal and foetal effect of treatment, and other religious and ethical issues in a multidisciplinary approach. In most cases, the woman can continue with the pregnancy. This chapter describes the management of vaginal and vulval cancer during pregnancy based on available case reports.