Transverse vaginal septum is a rare congenital malformation caused by incomplete canalization during embryonic development. It can be imperforate or perforated and cause obstructive or bleeding symptoms. Diagnosis can be made through physical examination, ultrasonography, and MRI. Complications include endometriosis, and the reproductive outcome needs further evaluation. Treatment involves surgical resection. Vaginal dilatation is performed in patients at high risk of vaginal stricture.