Vaginal precancerous lesions require intervention and are usually treated surgically. Vaginal intraepithelial neoplasia (VAIN), which can be categorized as mild atypical hyperplasia (VAIN I), moderate atypical hyperplasia (VAIN II), severe atypical hyperplasia (VAIN III), or carcinoma in situ. Vaginal precancerous lesions are VAIN II and VAIN III, which may be related to long-term persistent infection with high-risk types of human papillomavirus. Biopsy of abnormal vaginal tissues under colposcopy can confirm the diagnosis, and if no intervention is made, the lesions may develop into vaginal cancer, which is usually treated with surgery and regular follow-up after surgery. If precancerous vaginal lesions are detected, comprehensive assessment by a physician is required, and reasonable treatment under the physician’s guidance is necessary to avoid negligence and delay.