Objective To investigate the efficacy of ciclopirox olamine vaginal cream for treatment of vulvovaginal candidiasis(VVC). Methods According to the inclusion and exclusion criteria, 605 patients were enrolled in the present study from Jan. 2012 to Oct. 2013. The patients were randomly assigned to experimental group and the control group. Patients in the experimental group were given ciclopirox olamine ointment 5 g/d (ciclopirox olamine 0.05 g/d) for 7 days by vaginal delivery, and those in the control group were given miconazole nitrate suppositories 200 mg/d for 7 days in the same manner. The clinical efficacies of the two groups were compared. Results A total of 586 patients completed the study and the two groups had a good balance. The symptom remission rates 24 h after medication in the experimental group and the control group were 78.25% (223/285) and 41.86% (126/301), respectively, showing significant difference (P<0.01); and the total effective rates one week after treatment were 91.93% (262/285) and 85.05% (256/301), respectively, also showing significant difference between the two groups (P<0.01). The recurrence rates in 204 patients of the experimental group at 3 and 6 months after discontinuation were 0.49% (1/204) and 3.92% (8/204), while in 205 patients of the control group were 7.32% (15/205) and 14.15% (29/205), respectively, showing significant differences between the two groups at both time points(P<0.01). Conclusion Ciclopirox olamine vaginal cream is more effective than miconazole nitrate in treating VVC, and it can significantly reduce the recurrence rate.