Importance: Female genital cosmetic surgery (FGCS) is a growing area within the field of gynecology with an increasing number of patients asking providers about these services. Objective: This review aims to increase the knowledge surrounding the types of FGCS performed, the outcomes and complications of these procedures, and the controversy surrounding FCGS. Evidence Acquisition: This study is a review of the most recent peer-reviewed articles and review articles as well as guidelines and recommendations of the American College of Obstetrics and Gynecology. Results: Female genital cosmetic surgery is a broad term that encompasses multiple procedures including labiaplasty, vaginoplasty, clitoral hoodectomy, hymenectomy, labiamajora augmentation, and G-spot amplification. Minimal data exist regarding the long-term outcomes and complications associated with these procedures. There is also a paucity of literature comparing FGCS to less invasive alternatives. Significant controversy exists regarding FGCS, given the known variation in female genitalia, lack of safety data, and concern for proprietary conflict with these procedures. Conclusions and Relevance: Cosmetic gynecology surgery has become more popular in recent years, with few studies assessing the long-term benefits and harms of these treatments. Gynecologists should be aware of the lack of evidence supporting the effectiveness of FGCS in light of the growing marketing efforts and patient demand for these procedures. Target Audience: Obstetricians and gynecologists, family physicians. Learning Objectives: After completing this activity, the learner should be better able to compare the various types of female genital cosmetic surgery that are available, assess the outcomes associated with female genital cosmetic surgery, and examine the controversies that surround female genital cosmetic surgery.