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In the context of human microbiota, the vagina is a complex anatomical site with several species of microorganisms coexisting in a mutual relationship that contribute in the maintenance of normal vaginal environment necessary for a healthy state. Abnormal vaginal discharge is one of the most common clinical presentations among women of reproductive age and multiple etiologies exist with bacterial vaginosis (BV) being the commonest globally. Bacterial Vaginosis is a complex polymicrobial clinical syndrome which occurs usually in women of childbearing age due to imbalance in the resident flora notably Lactobacillus specie and Gardnerella vaginalis. Clinically BV generally present with copious, thin, homogeneous, milky, foul-smelling vaginal discharge. Vaginal pH of > 4.5 and presence of “clue cells” on microscopy are among the major diagnostic features. Generally, BV is associated with increased risk of acquiring sexually transmitted infections and other adverse outcomes. Gynecologic complications associated with the disease include cervicitis, salphingitis, endometritis, post-operative infections and pelvic inflammatory disease while obstetric complications include premature rupture of membranes, preterm deliveries, chorioamnionitis and postpartum endometritis. BV has been associated with poverty, smoking, increasing body mass index, misuse/abuse of antibiotics, race/ethnicity, increasing lifetime sex partners, various intravaginal practices (e.g. douching) and low level of education. The aim of this review is to highlight the clinical relevance of BV with emphasis on the role of numerous predisposing/risk factors in dis-stabilizing the vaginal flora and subsequent challenges associated with several complications and consequences including sexually transmitted infections in the context of being a prelude or sequelae., {"references":["Filho DS, Diniz CG, Silva VL. Bacterial vaginosis:Clinical, epidemiologic and microbiological features. 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