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Background: Labia minora labiaplasty is becoming a more frequently requested cosmetic procedure. In 1976, Radman first described labia minora labiaplasty. Since that time, different surgical techniques have been published and non-surgical procedures have been introduced. These cosmetic procedures remain controversial because of deceptive marketing practices and the lack of evidence-based medicine to support them. Objective: To review the existing surgical and non-surgical methodologies of labia minora reduction literature with emphasis on surgical outcome and patient satisfaction. Methods: Electronic and manual literature searches were conducted on labia minora reduction in the English language utilizing Google Scholar from 1970 to December 2018. A targeted methodological review and analysis of surgical and non-surgical techniques was apprised. Results: Several published articles in peer review journals and anecdotal information on labia minora reduction surgical and non-surgical techniques were identified. Review of the existing literature established that the safety and effectiveness of labia minora reduction surgery for aesthetic purposes has not been determined. The non-surgical RF literature is available, but no scientific data on the safety and effectiveness of these devices is being presented. However, due to the variations in the labia minora presentation, there is not a single procedure that can be utilized for labia minora reduction. Conclusion: Well-designed and well-executed clinical studies are needed to make appropriate clinical-scientific progress for labia minora reduction for cosmetic purposes. Furthermore, standards of care must be established by organizations, such as ACOG and ASPS, to protect women against unethical practices that put her at risk for unfavorable outcomes.