Background <p>Vesicovaginal fistula (VVF) is an abnormal fistulous tract between the urinary bladder and vagina, which results in continuous urinary incontinence. It is associated with significant morbidity and social outcast of patient. There are many surgical methods to repair VVF such as transvaginal approach, transabdominal approach or transvesical approach, but the standard approach is still debated. The main objective of this study was to study the feasibility of transvaginal VVF repair in current era.</p> Methods <p>A retrospective review of the medical records of 45 patients, who underwent transvaginal VVF repair at our center from January 2020 to November 2024, was performed. Patients with vaginal stenosis or having associated injuries like uretero-vaginal fistula were excluded from the study. Clinical data of patient including perioperative data and outcomes were recorded, and analysis was done. The primary outcome was successful closure of VVF as defined by lack of leakage of urine after removing the foleys catheter.</p> Results <p>The mean age of the patients was 36.1yr. The time to presentation ranged from 4 weeks to 7 years. The VVF was successfully closed in 42 patients after the initial surgery, and failure was observed in three patients. Initial failures were cured successfully after a second transvaginal repair with interposition of Martius flap. No major complication was observed in any of the patient.</p> Conclusions <p>Transvaginal approach to repair VVF is still a simple, effective, and feasible approach with acceptable rate of success at minimal cost especially in resource poor developing countries like India.</p>