Although not life-threatening, trichomoniasis is a major health problem, especially in women. It is transmitted sexually and has a very high incidence worldwide. We argue that Trichomonas vaginalis is not a commensal. Attempts should be made to identify this pathogen in all suspicious cases. Although culturing remains the most sensitive method to detect T vaginalis, newer methodologies such as monoclonal antibody fluorescent and direct staining make it possible to diagnose an infection with high sensitivity and specificity and to treat the patient at the same visit. Treatment is effective, approaching a 100% success rate when sexual consorts are also treated. Only by aggressive attempts to diagnose and treat this disease can we stop its spread.