A comparative study was conducted to compare the results of the use of oral and local vaginal therapy in the treatment of vaginal candidosis. Forty-five patients with clinical and mycological evidence of vaginal candidosis were recruited and were randomly allocated to one of the treatment groups. Twenty-four patients received ketoconazole orally (400 mg/day for 5 days) and 21 patients received nystatin vaginal pessaries (100,000 units twice/day for 7 days). Seven out of 20 rectal swabs (35%) were positive for Candida albicans. Both drugs were significantly effective in relieving patients symptoms and physical signs. The mycological cure rates were 87.5% and 81%, and the relapsing rates were 0% and 5.9% for the ketoconazole and nystatin groups, respectively. Ketoconazole oral therapy had generally slightly higher results than local nystatin therapy in the treatment of vaginal candidosis, yet the difference was statistically insignificant.