Vaginal atresia can be congenital or acquired. Congenital vaginal atresia is a complete or incomplete vaginal atresia caused by abnormal embryonic development before birth; acquired vaginal atresia is a vaginal atresia caused by postnatal trauma, drug erosion, etc. Congenital vaginal atresia is the most common clinical condition. Congenital vaginal atresia, as the name implies, is a complete or partial inaccessibility of the vagina, i.e., no vagina between the rectum and the urinary bladder, mostly accompanied by cervical atresia, with normal secretion of the endometrium. In congenital vaginal atresia, congenital atresia is said to be due to the fusion of bilateral mullerian ducts and the developmental disorders of the mullerian nodes and/or urogenital sinuses. In 1976, Simpson suggested that vaginal atresia differs from congenital absence of uterus and vagina in that the former is the result of defective development of the genitourinary sinuses, with more normal uterine development, which may be combined with cervical dysplasia, whereas the latter is the result of hypoplastic Mullerian ducts and presents with absence of both uterus and vagina. Up to now, the general textbook description of vaginal atresia is still only lower vaginal atresia with normal uterine development, and the clinical manifestation is cyclic lower abdominal pain due to the absence of menstrual blood during puberty. After nearly half a century, the understanding of vaginal atresia is no longer limited to lower vaginal atresia, and the discovery of new clinical cases has led to advances in the theory of embryonic development. Based on the anatomical features and the developmental studies, we have explored the diagnostic criteria for the typing of vaginal atresia: Type I: vaginal atresia of the lower vagina with normal development of the upper vagina and uterus; Type II: complete vaginal atresia, which may be combined with cervical atresia, normal or malformed uterine body, and normal endometrial secretion; Type III: vaginal atresia of the upper vagina, which may be combined with cervical atresia, normal or malformed uterine body, and normal endometrium Type IV: Atresia of the apical vagina, combined with cervical atresia, normal or malformed uterine body, and normal endometrial secretion. Vaginal atresia is usually combined with cervical atresia, which is characterized by periodic lower abdominal pain and pelvic mass formation during puberty without menstruation. Once diagnosed, it should be treated promptly. The management plan for vaginal atresia should be designed according to the development of the uterus: type I vaginal atresia can be treated by surgically opening the vaginal channel and making the vagina rough and superficial; type IV vaginal atresia with a combined primordial uterus does not require treatment; type II, III and IV vaginal atresia with cervical atresia should be treated according to the cervical atresia typing to decide the timing of uterine removal and vaginoplasty. Type I cervical atresia can be treated by preserving the uterus and performing cervical and vaginoplasty via the perineal route alone; type II and III cervical atresia should be treated by hysterectomy and vaginoplasty before marriage; type IV cervical atresia can be treated by either hysterectomy before marriage or cervical and vaginoplasty via the transabdominal perineal route according to the request of the affected party.