Vulvar epidermoid cysts, though rare, can occur on the labia minora. Differentiating these from other vulvar lesions and managing large, symptomatic cysts is challenging due to limited literature. This case highlights the need for comprehensive clinical evaluation, including history, exam, and imaging, to accurately diagnose and manage these rare cysts. Surgical excision is often recommended, considering potential complications. Further documentation is needed to improve the diagnosis and management of vulvar epidermoid cysts.