The complaint of vaginal discharge is the most common diagnosis involving gynecological complaints in the primary care setting (Paladine and Desai, Am Fam Physician 97(5):321–329, 2018). Symptoms include discharge with or without odor, which may be accompanied by dysuria, vulvar, and/or vaginal itching or burning. Most patients will have at least one vaginal infection during their lifetime. A careful history that includes inquiry about new or multiple sexual partners, type of birth control, sexually transmitted infection prevention measures, current health status, medications used, vaginal hygiene practices, and vaginal preparations used will help with the diagnosis. Symptoms alone cannot make the diagnosis of vaginitis. The practitioner must evaluate the vaginal mucosa with a speculum exam and obtain a sample of the vaginal discharge. The discharge should be evaluated by doing a pH test, a whiff test, and saline and potassium hydroxide (KOH) wet mount slides viewed under the microscope. There are several commercial kits available that help to identify the most common causes of vaginal discharge. Commercial tests for Trichomonas vaginalis have higher sensitivity and specificity than wet mount.