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Objective: To evaluate the surgical feasibility and the long-term anatomical and functional results of the technique of vaginal reconstruction using peritoneum from the pouch of Douglas in patients with uterovaginal agenesis, known as Rokitansky's syndrome., Design: Retrospective single-institution case series., Setting: A tertiary referral center for the treatment of female genital malformations., Patient(s): Forty-eight patients with vaginal agenesis., Intervention(s): Laparotomy and use of pelvic peritoneum to form a neovagina., Main Outcome Measure(s): Anatomical success was defined as a neovagina > or =8 cm in length that easily permitted the insertion of two fingers 6 months after corrective surgery. Functional success was considered to have been achieved when the patient reported satisfactory sexual intercourse beginning 6 months after surgery., Result(s): The surgical procedure was carried out uneventfully, and anatomical success was achieved in 100% of cases. Functional success was also achieved in the entire population studied., Conclusion(s): The construction of a neovagina using pelvic peritoneum is simple, safe, and effective in patients with Rokitansky syndrome.