Infections such as vulvovaginal candidiasis, Acquired Immunodeficiency Syndrome (AIDS), and others profoundly affect women's health globally. Recent statistics indicate that millions of women are affected by these conditions worldwide. Intra-vaginal drug delivery has emerged as a common treatment modality for managing female health issues. Microneedles have gained attention as a preferred option for intravaginal delivery, offering promising solutions for diseases related to the vagina. Microneedles are used in the delivery of therapeutically active agents such as antiretroviral drugs, probiotics, antigens, and adjuvants. They provide customized release of drug molecules, good stability, mechanical properties, rapid dissolution time, and improved therapeutic outcomes, which can further enhance health management effectively. Therefore, this book chapter provides an overview of microneedles for intravaginal delivery and addresses the challenges associated with achieving optimal drug levels at the targeted site. A detailed discussion on vaginal infections and the necessity of microneedles are included in this book chapter. Additionally, the types and criteria for microneedles, along with the materials used in intravaginal delivery, are briefly outlined. The application of microneedles for delivering therapeutically active agents such as antifungal, probiotics, and antiretroviral drugs is also discussed briefly. Finally, a summary of current challenges, prospects, and key insights related to microneedle design for intravaginal delivery is included.