Women (33) with carcinoma of the clitoris underwent surgical therapy, and 12% subsequently developed pelvic recurrence. None of the 18 patients without initial evidence of inguinal node metastases developed a pelvic recurrence. Of the 15 women with initial evidence of inguinal node metastases, 26.6% developed pelvic recurrence. The addition of the routine use of pelvic lymphadenectomy to radical vulvectomy and bilateral inguinal lymphadenectomy in women with carcinoma of the clitoris is not warranted and only those patients with histologically proven inguineal node metastases should undergo pelvic lymphadenectomy. If pelvic node metastases are documented, such patients should receive postoperative pelvic irradiation.