Butoconazole nitrate, a newer imidazole, is effective for the treatment of vulvovaginal candidiasis when administered as a vaginal cream. The microbiologic and clinical cure rates achieved with a 3-day course of butoconazole 2% cream have been comparable with those obtained with a 6-day course of miconazole nitrate 2% cream or a 3-day course of clotrimazole vaginal tablets (200 mg/day). Patients taking oral contraceptives have responded as favorably as those using other forms of birth control or none whatsoever. In addition, both microbiologic and clinical cures resulting from a 3-day regimen of butoconazole 2% cream have been sustained for at least 4 weeks. The high degree of efficacy and safety demonstrated by this short treatment regimen offers an advantage in the management of patients with vulvovaginal candidiasis, many of whom are likely to abandon any therapy as soon as their clinical symptoms have subsided. A clinical assessment of butoconazole vaginal suppositories (100 mg/day) and clotrimazole vaginal tablets (200 mg/day) found that the two therapies were comparably safe and effective when administered for 3 days. The suppository form of butoconazole may offer a valuable therapeutic alternative for patients who wish to use it instead of or in conjunction with vaginal cream.