Research on the vaginal microbiome and its relation to women’s health has steadily gained momentum in recent years. Traditionally, vaginal microbiome studies have focused on the pathogenesis of various diseases. Recent publications focus more on health and support a key role for Lactobacillus species and their dominance in maintaining a healthy state in the human vagina. In this narrative review, we synthesize promising novel insights related to vaginal microbiota published from April 2021 to March 2022. Hereby, we focus specifically on advances in understanding the vaginal microbiota composition by using innovative sequencing and detection tools. In addition, microbiota composition-influencing factors, potential microbe-based diagnostics and therapies are discussed.