The aim of this study is to validate the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) in Portuguese. Two hundred four women (108 symptomatic, 94 asymptomatic, and two with no data) with mean age of 55.4 years received a Portuguese version of the ICIQ-VS. Clinical data and pelvic organ prolapse quantification index (POP-Q) were obtained. Retest was performed 3 weeks later. Responsiveness was assessed after 20 weeks of postsurgical follow-up. Overall, most patients presented POP-Q > 2. ICIQ-VS demonstrated good psychometric properties (validity, reliability and responsiveness). The test-retest reliability was moderate to excellent for all questions. The construct validation distinguished differences in ICIQ-VS scores between symptomatic (ICIQ-VS5a > 0) and asymptomatic (ICIQ-VS5a = 0) women. ICIQ-VS was highly responsive to surgical treatment and discriminated between levels of change in the vaginal symptoms score, sexual matters score, quality-of-life score, and POP-Q. 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