Labial fusion is a state of partial or complete adhesion of the labia minora generally occurring in young girls or post-menopausal women but is extremely rare in females after attaining puberty. The relative hypoestrogenic environment is suggested as the main predisposing factor of this condition in the prepubertal girl. In adults, including postmenopausal women, labial fusion is associated with recurrent urinary tract infections, vulvovaginal infections, poor personal hygiene, genital trauma, hypoestrogenism, underlying dermatological disease, and lack of sexual activity. Labial adhesion is rare in females of the reproductive age-group due to the abundance of estrogen. It is generally asymptomatic but can also present with complaints of urine pooling in the vagina on voiding, followed by leakage from the vagina on activity after voiding or changes in the direction of the urine stream. In about 20% of girls, asymptomatic bacteriuria develops, and up to 40% experience symptomatic urinary tract infections. The condition usually resolves once they attain puberty, so aggressive treatment is not recommended unless the patient is symptomatic. Medical or surgical management options are available. Topical estrogen application is considered as the first line treatment for labial adhesions, especially for superficial labial adhesions in prepubertal girls and postmenopausal women. Conjugated estrogen cream or estradiol vaginal cream (0.01%) can be applied to the adhesions 1–2 times daily for several weeks until the adhesion resolves. Adverse systemic effects from estrogen application are rare and include local irritations, vulvar pigmentation, and breast enlargement. An alternative line of treatment is topical 0.05% betamethasone cream. One to three courses of twice-daily application of topical betamethasone for 4–6 weeks showed promising results. In addition, manual separation of adhesions with care and maintenance of local hygiene is also reported to resolve labial adhesions. Surgical adhesiolysis is the treatment of choice in pubertal girls and in patients with previous treatment failure. Local estrogen might not prove to be beneficial in such cases.