Embryonal Rhabdomyosarcoma is the most common malignancy of the vagina in infants and children. Most common subtype of embryonal rhabdomyosarcoma is sarcoma botyroidesSeen in infants and children less than 5 years of age. "This rare tumor develops almost exclusively in girls younger than 5 years, although vaginal and cervical sarcoma botryoides have been reported in females aged 15 to 20 years."  - William Gynae 1st /ed p 683 "Sarcoma botryoides are usually seen in patients who are younger than 5 years of age." - COGDT 10th ed p 831 In infants and children, sarcoma botyroides is usually found in vagina, in reproductive age females rhabdomyosarcoma is seen within the cervix and after menopause within the uterus. The gross appearance of the tumor resembles pinkish bunch of grapes —it can be in the form of multiple polyp like structures or can be a solitary growth with pedunculated appearance. Histologically-its characteristic finding is "rhabdomyoblast."Clinical features The presenting features are:Blood stained vaginal discharge Anaemia and cachexiaManagement Chemotherapy — vincristine actinomycin D and cyclophasphamide followed by conservative surgery to excise residual tumor is the treatment of choice. Newer studies have revealed that primary chemotherapy without surgery is adequate for most patients.