Objective The main objective is to analyze ERAS’s impact on vulvar oncology surgery. Design Retrospective observational cohort study Setting A single center, an academic reference center, and main referral for gynecology oncological patients in Quebec province, Canada. Population or Sample All patients who underwent surgery for vulvar cancer (or suspicious lesions) from the pre-ERAS (2015) and ERAS (2019-2021) periods were included. Methods The length of stay, postoperative complications, readmissions, reoperation and mortality rate were compared between pre-ERAS and ERAS cohorts. CHUM’s practices were compared to ERAS guidelines recommendations and ERAS Interactive Audit System (EIAS®). Proportions were used to analyze compliance with available guidelines. Main Outcome Measures The primary outcome of this study is ERAS’ impact on vulvar oncology surgery outcomes. Other outcomes include the analysis of CHUM’s compliance to ERAS guidelines and EIAS® ability to evaluate compliance for vulvar surgeries. Results 154 patients were included. Compliance increased from 28.5% % to 85.7%. We observed a reduction in length of stay (p=0.002), hospitalization complications(p=0.033) [respiratory (p=0.009), psychiatric (p=0.012) and pain (0.047)], hospitalization serious complications (p=0.011), postdischarge wound infections (p<0.001) with similar postdischarge complication rates (p=0.598). EIAS compliance algorithm only correctly interpreted 21.4% of recommendations. Conclusions ERAS implementation is beneficial regarding vulvar cancer surgery outcomes. All applicable guidelines should be grouped into a single checklist. EIAS compliance algorithm should be adapted to vulvar surgery. Funding This study received one scholarship grant from the PRogramme d’Excellence en Médecine pour l’Initiation En Recherche. Keywords ERAS, guideline, vulvar cancer, surgery, EIAS