"Surgical (re)construction of a vagina (vaginoplasty) is performed in biological women with congenital or postablative vaginal absence and in transgender women. Penile inversion vaginoplasty is the gold surgical standard for genital Gender Affirmation Surgery in transgender women. In absence of sufficient penoscrotal skin, due to penoscrotal hypoplasia, circumcision, penile trauma with loss of penile skin quantity and/or quality, or when primary vaginoplasty has failed, intestinal vaginoplasty can be performed. This article provides an update on surgical indications of intestinal vaginoplasty, operative technique, perioperative care, and short- and long-term postoperative issues. A review of recent literature is performed."