Congenital absence of vagina and uterus is commonly known as “stone girl”. Congenital anovagina is a congenital malformation of the genital tract, often combined with an absence of a uterus or an undeveloped uterus. Congenital anovaginal anomalies are most often detected by the absence of menstruation after puberty. The majority of patients have well-developed breasts during puberty and have visible female secondary sexual characteristics. The reason for the absence of menstruation is that most patients have no uterus or only a primordial uterus (a non-functioning uterus); if there is an endometrium with uterine hypoplasia, the patient may have periodic abdominal pain due to stagnation of menstrual blood. These patients are often found when they visit the clinic with primary amenorrhea after puberty or difficulty in sexual intercourse after marriage. The congenital anovaginal patient without a uterus or with only a primordial uterus has no possibility of having children, but the vagina can be reconstructed by medical means for the purpose of sexual life. The best time to operate is when you have a boyfriend and are ready to get married. The main treatment for congenital anovaginismus is surgery, except for non-surgical vaginalization by parietal compression, which is known as vaginoplasty. The procedure involves separating a cavity about 8-10 cm long between the bladder and rectum and covering the four walls of the cavity with various tissues and filling them with gauze so that the tissues grow close to the four walls. After about 7-10 days, the covered tissue grows well and can be replaced with a rigid model to ensure that the vagina does not collapse and to prevent tissue contracture. Currently there are more than 20 vaginoplasty procedures with different names depending on the bedding used for artificial cavity creation. The most common ones are: amniotic vaginoplasty, peritoneal vaginoplasty, sigmoid vaginoplasty, flap vaginoplasty and biological patch vaginoplasty. Each of these methods has been used in clinical practice for different periods of time and has different advantages and disadvantages. The main surgical treatment methods and their advantages and disadvantages are described as follows: I. Biologic patch vaginoplasty: Medical tissue patches are currently used both at home and abroad to cover the four walls of the artificial vagina for the purpose of vaginal reconstruction. It is a natural extracellular matrix obtained by decellularization of allogeneic tissues using tissue engineering techniques and is a dermal substitute. The most distinctive feature of this new material is that it is non-toxic as well as histocompatible and does not trigger immune rejection by the body. The procedure is a simple, 30-minute procedure under intravenous anesthesia, with few complications and bleeding, and most of the vagina is mucosalized 4-12 weeks after the procedure. Compared with other methods, it has the advantages of short operation and anesthesia time, short postoperative mucosalization time, shortening the time needed to wear the mold, and the vaginal mucosa formed is thick, smooth, red, and elastic, and the scar formation and contracture are not obvious, thus greatly improving the patient’s quality of life. However, the disadvantages are the high cost and the tendency of the reconstructed vaginal tip to grow granulation tissue. Peritoneal vaginoplasty: With the development of minimally invasive technology and the perfection of laparoscopic technology, peritoneal vaginoplasty, which is done by separating the peritoneum of the pelvic wall through the laparoscopic route and then pulling down and lining the cavity separated from the vagina, is also widely carried out. After clinical practice, our laparoscopic peritoneal vaginoplasty has significantly higher postoperative vaginal depth and sexual satisfaction than the traditional amniotic method. Amniotic vaginoplasty: This procedure uses fresh amniotic membrane as a temporary biological dressing, which has a high growth rate and can prevent wound infection and act as a fibrous scaffold. After the operation, the mucosal epithelium of the vestibule can grow into the lumen along with the scaffold, and the final vagina formed is usually similar to the natural vagina after 3-6 months. This surgical method is the easiest and safest to operate, but should be performed with strict aseptic technique, otherwise it is prone to failure due to infection. In amniotic vaginoplasty, the artificial vagina should not be separated by more than 8 cm, otherwise infection often occurs secondary to defective growth of the apical mucosa. The advantages of amniotic method vaginoplasty are low cost, short operation and anesthesia time, but much postoperative discharge. Ileo- and sigmoid vaginoplasty: This procedure involves opening the abdomen to free a section of the sigmoid colon that maintains blood flow and transplanting it into the formed vaginal cavity. Since this procedure directly uses the intestine as a substitute for the vagina without the crawling growth of the vaginal mucosa epithelium, the vagina is not contracted after surgery and can remain wide and unobstructed without the need for a vaginal model. However, the procedure is complicated and traumatic to the patient, and the recent secretion of intestinal fluid and vaginal odor bring inconvenience to the patient’s life. V. Self-flap vaginoplasty: This procedure is performed by taking the patient’s own skin and transplanting it into the vaginal cavity. It is commonly used to take skin flaps from the inner thighs, vulva, both groins, abdomen, etc. The survival rate of skin flaps is high and the success rate of the operation is high. However, postoperative scars are evident in the donor area, hair growth is present after abdominal skin slice formation, and the formed skin vagina is dryer due to its non-secretory function, resulting in a less than satisfactory sex life. It is important to note that the best time to have the surgery is when the patient is ready or already married, otherwise it is inconvenient to wear a mold for a long time after the surgery and it is difficult to operate again once the artificial vagina has collapsed or contracted. In addition, since most patients with congenital anovagina are combined with an anovaginal or primordial uterus, they can have normal sexual intercourse but cannot have children after the formation of an artificial vagina. In recent years, the authors have used laparoscopic peritoneal vaginoplasty in these patients, which is minimally invasive, less painful, and has high postoperative sexual satisfaction.