A positive leukocyte esterase indicates the presence of leukocytes, or neutrophils, in the specimen tested, indicating the presence of inflammation in the vagina. However, further tests are needed to determine which type of vaginitis is present. Leukocyte esterase is a specific enzyme contained in human leukocytes. When there is inflammation in human tissues, the chemotaxis of multinucleated leukocytes accumulates in the inflammatory lesions and releases large amounts of leukocyte esterase, so when there is vaginal inflammation, the leukocyte esterase activity in the cervical and vaginal mucosa is also elevated. In general, leukocyte esterase is not detected in women’s leukorrhea secretions, but when women have gynecological diseases such as mycosis fungoides, bacterial vaginitis, trichomoniasis, or chronic cervicitis, the inflammatory secretions are excreted along with the shed epithelial cells, so the presence of leukocyte esterase is detected in women’s leukorrhea. Moreover, a positive leukocyte esterase is usually a Gram-negative bacterial infection, but leukocyte esterase lacks specificity, and even if it is detected as positive, it only indicates an infection, and it is not clear which pathogenic bacterial infection is present. When a woman is tested positive for leukocyte esterase, further ultrasound, colposcopy or culture of secretions of the uterine adnexa are needed to identify the specific pathogenic bacteria and then treat it with the right medication.