Correct diagnosis of disease, staging of malignancies and detection of primary or secondary abnormalities of the adjacent pelvic organs are the basic requirements of preoperative diagnostic procedures in gynecological disorders. The latter is usually done by ultrasound, intravenous pyelography and endoscopic examination of the bladder and the colon. The diagnosis of disease with respect to malignancies of the uterus, vagina and vulva can usually be made by clinical examination and histology obtained by biopsy. On the other hand, ovarian tumors cannot be sufficiently differentiated by clinical methods. Ultrasound, magnetic resonance imaging and computed tomography may be helpful, but definitive diagnosis usually requires a surgical approach. This is also true for staging of gynecological malignancies. Nevertheless, improvements in preoperative diagnostic procedures allow individualized planning of surgery and improved staging in patients treated primarily by radiotherapy.