Background: Vulvar Lichen Sclerosus (VLS) is a mucocutaneous disorder of chronic inflammation that significantly impacts the biopsychosocial well-being of affected women. VLS is characterized by hypopigmentation, skin atrophy, pruritus, and vulvodynia. The pathophysiology of VLS is primarily linked to the infiltration of activated T-cells stimulating fibroblasts by cytokines, resulting in altered collagen production and fibrosis. Limited research investigates the vulvar microbiome's composition in healthy individuals compared to individuals with VLS. This study aims to address the existing gap by exploring the diverse vulvar microbiome in patients with VLS and examining the potential role of microbiome alterations in the disease's pathogenesis. Methods: A comprehensive review of literature was conducted to explore the relationship between the vulvar microbiome and VLS. Studies were selected based on relevance to microbial diversity and VLS pathogenesis. Results: The vulvar microbiome comprises bacteria from the vulvar skin, vaginal canal, colon, and anus, resulting in a unique and diverse microbial environment that is relatively underexplored. Studies have demonstrated that when healthy skin is transplanted to areas affected by VLS, the transplanted skin can develop characteristics of VLS. This suggests that the microenvironment of the vulvar skin may play a significant role in the pathogenesis of VLS and highlights the importance of preventative measures to maintain vulvar skin health. Common bacteria identified in the vulvar microbiome include Lactobacillus and Prevotella. In healthy individuals, Lactobacillus is the dominant bacterium. In contrast, more than 85% of symptomatic VLS patients exhibit an increased presence of Prevotella. Elevated levels of Prevotella have been shown to stimulate epithelial cells to produce cytokines leading to Th17-mediated mucosal inflammation. These findings emphasize the critical role of microbial balance in vulvar health and suggest that targeting specific microbial alterations could offer new avenues for preventing and managing VLS. Conclusion: There is an observed association between microbiome diversity and VLS. Future research should investigate the role of specific bacteria, such as Prevotella, in the pathogenesis of VLS. The current body of literature on the vulvar microbiome and its connection to chronic inflammatory diseases, including VLS, is limited. To address this significant gap, increased awareness and dedicated research efforts are essential.