The name of bacterial vaginosis has been changed several times, starting with Haemophilus vaginitis about 20 years ago, and then being changed to Gardnerella vaginitis after a large number of Gardnerellae were found in the vaginal fluid of patients. Subsequently, it was found that Gardnerella was not only detected in the vaginal fluid of patients with bacterial vaginosis, but also in the vaginal fluid of normal non-pregnant women at a rate of 16.6%, thus renaming Gardnerella vaginitis as non-specific vaginitis. The current methods of detecting bacterial vaginosis are constantly updated with bacterial cultures, immunological methods, immunological fluorescence, DNA probes, PCR, etc. The update of detection methods has led to more in-depth studies on the pathogenicity of the detected Gardnerella. Research data show that the pathogenicity of Gardnerella is related to its biotyping, etc. At present, PCR amplification is used to detect Gardnerella genes for biotyping, making it possible to detect pathogenic Gardnerella with a sensitivity and specificity of more than 98%. In recent years, numerous studies have demonstrated that many other microorganisms are related to the pathogenesis of bacterial vaginosis. In addition to pathogenic Gardnerella, there are also a large number of anaerobic bacteria such as Bacteroides actinomycetemcomitans, Prevotella, Zygomycetes, Bacteroidetes, Streptococcus pepticus and human mycoplasma in the vaginal fluid of patients. The number of anaerobic bacteria can increase by 100-1000 times, while the normal hydrogen peroxide-producing Lactobacillus in the vagina is greatly reduced, making it easier for the anaerobic bacteria to multiply in the vagina and producing a fishy odor in the vaginal discharge. Bacterial vaginosis is actually an imbalance in the ecological balance of bacteria that normally live in the vagina (dysbiosis). Under physiological conditions, the vagina contains a variety of anaerobic and aerobic bacteria, with Lactobacillus, which produces hydrogen peroxide, predominating. In bacterial vaginosis, the number of lactobacilli in the vagina decreases, while other bacteria multiply, and some patients have a combination of mycoplasma infections, in which anaerobic bacteria predominate. The anaerobic bacteria can produce amines that alkalize the vagina and increase the vaginal discharge and make it smelly. Patients with bacterial vaginosis only notice an increase in vaginal discharge and an abnormal odor (such as the fishy smell of dead fish and shrimp), but doctors often do not see any clinical or pathological inflammatory changes in the patient, so it is not vaginitis. It is now believed that bacterial vaginosis is a mixed infection caused by a dysbiosis of the normal vaginal flora resulting in the combination of certain anaerobic bacteria, pathogenic Gardnerella vaginalis and Mycoplasma humanum and Mycoplasma genitalium. The presence or absence of clinical symptoms varies significantly with the number distribution of the various pathogenic microorganisms in the patient’s dysregulated vaginal flora. Current studies suggest that the cause of the changes in the vaginal flora remains unclear, and it is only speculated that it may be related to frequent sexual intercourse, multiple sexual partners, or alkalinization of the vagina by vaginal irrigation (douching). Forty percent of patients with bacterial vaginosis are asymptomatic, while those with symptoms have an increased vaginal discharge with a foul odor, which may be accompanied by mild vulvar itching (e.g., paroxysmal ant crawling) or a burning sensation. The vaginal discharge is white, off-white or yellowish and stains the underwear as a uniform and thick layer of powdery discharge with a fishy odor. On examination, the doctor sees that the vaginal mucosa is often not congested with inflammation and that there is more vaginal discharge, which is usually a uniform thin, low viscosity white paste or translucent paste, some of which can be seen to be foamy. The vaginal discharge can smell foul. The vaginal discharge is examined for absence of mycobacteria, trichomonas and gonococcus. And the examination of vaginal discharge can find a large number of gram-positive small bacilli, gram-positive cocci, gram-negative bacilli, and vibrios under the microscope. The characteristic diagnosis is to find clue cells under the microscope. The clue cells are superficial cells shed from the vagina. The granular material attached to the top and edge of the shed cells is Gardnerella, which appears to have indistinct edges. The typical morphology of Lactobacillus is rarely found in vaginal secretions. Treatment of bacterial vaginosis is tricky because it is a mixed infection with dysbiosis of the vaginal flora and because the distribution and levels of the various microorganisms that cause the disease vary greatly. This is because the use of vaginal plugs or vaginal douching is not effective. Treatment is usually by oral antibiotics. The medication chosen needs to be effective against both anaerobic and aerobic bacteria and should be taken for a long enough course of 10-14 days. The spouse or sexual partner must also be treated with the same medication for a course of treatment after cure, otherwise the infection will be reinfected.