Fresh, direct, and phase contrast microscopy is an easy-to-perform, replicable, and economical diagnostic technique included in the guidelines of the Centers of Disease Control of Atlanta in 2015. Vaginal fresh cytodiagnostics offers real time precious information on the females hormonal status and cervical-vaginal infections without the need for fixation and staining of the specimen. This practical highly-illustrated atlas offers state of the art information on the most recent advances in the use of Microscopy in gynecologic practice.