Only few population-based incidence analyses of vulvar melanoma including the United States and Sweden are currently available. We studied the incidence of v ulvar melanoma in a large population-based cancer registry ofEast Germany and c ompared our findings with the United States and Sweden. We extracted vulvar mela noma registered between 1976 and 1989 in the former National Cancer Registry of the German Democratic Republic (GDR) and of three new East German cancer registr ies of the federal states of Sachsen, Brandenburg, and Mecklenburg-Vorpommern o f the period 1998 to 2002. We calculated age-specific and age-standardized inc idence rates using the World Standard Population. One hundred two cases (1976198 9, former GDR) and twenty-five cases of vulvar melanoma (1998-2002, three new federal states) were registered. The age-standardized incidence rate (World Sta ndard Population)-remained constant over the period from 1976 to 1989 and range d between 0.26 and 0.52 cases per million. From 1998 to 2002, the incidence rate was 0.48 per million. The ratio of registered vulvar melanoma to skin melanoma was 1:71, and the ratio of vaginal melanoma to skin melanoma was 1:314. Age at d iagnosis during the period 1976 to 1989 was lower among women with vulvar melano ma (median age 70 years) compared to women with vulvar tumors other than melanom a (median age 73 years). The risk of vulvar melanoma was considerably lower in E ast Germany than in the United States and Sweden. Due to the rarity of vulvar me lanoma, population-based cancer registries are hampered to study this tumor in detail. Only few population-based incidence analyzes of vulvar melanoma including the United States and Sweden are currently available. We studied the incidence of v ulvar melanoma in a large population-based cancer registry of East Germany and c ompared our findings with the United States and Sweden. We extracted vulvar mela noma registered between 1976 and 1989 in the former National Cancer Registry of the German Democratic Republic (GDR) and of three new East German cancer registries ies of the federal states of Sachsen, Brandenburg, and Mecklenburg-Vorpommern of the period 1998 One hundred two cases (1976198 9, former GDR) and twenty-five cases of vulvar melanoma (1998-2002, three new federal states) were registered. The age-standardized incidence rate (World Ståndard Population) -remained constant over the period from 1976 to 1989 and range d between 0.26 and 0.52 cases per million. From 1998 to 2002, the incidence rate was 0.48 per million. The ratio of registered vulvar melanoma to skin melanoma was 1:71, and the ratio of vaginal melanoma to skin melanoma was 1: 314. Age at d iagnosis during the period 1976 to 1989 was lower among women with vulvar melano ma (median age 70 years) than women with vulvar tumors other than melanom a (median age 73 years). The risk of vulvar melanoma was quite lower in E ast Germany than in the United States and Sweden. Due to the rarity of vulvar me lanoma, population-based cancer registries are hampered to study this tumor in detail.