Vulvodynia is an umbrella term referring to idiopathic chronic vulvar pain of at least 3 months’ duration. By the age of 40 years, 7–8% of women will have experienced vulvodynia symptoms. The etiology of this neglected condition is multifactorial, involving several interacting biopsychosocial factors. Given the myriad factors involved in the development and maintenance of vulvodynia and its associated negative consequences on sexual, psychological, and relationship well-being, a comprehensive treatment plan is suggested. Such plans often involve medical, pelvic floor, and psychotherapy interventions. The most rigorously studied and widely used psychotherapy approach for vulvodynia is cognitive-behavioral therapy (CBT). Group, couple, and individual CBT have been shown to be efficacious in reducing pain and improving sexuality and psychological outcomes in afflicted women and their partners. Targets of intervention include (1) reconceptualizing vulvodynia as multidimensional and multifactorial, (2) reducing pain- and sexuality-related anxiety, distress, and avoidance via skills training and behavioral activation, (3) promoting communication of sexual needs and preferences, and (4) fostering self-efficacy. More treatment research among samples that account for cultural, sexual, and gender diversity is needed to provide evidence-based, culturally competent, and inclusive clinical care.