Objective: To explore the value of quantitative vaginal microbiota scoring combined with biochemical markers in the diagnosis of recurrent vulvovaginal candidiasis (RVVC). Methods: 80 patients with RVVC who visited our hospital from May 2020 to May 2025 were selected as the observation group, and 80 healthy women who underwent physical examinations during the same period were selected as the control group. Perform vaginal microbiota quantification scoring (Nugent score) on two groups of subjects, and detect the levels of biochemical markers such as leukocyte esterase, acetylglucosidase, and hydrogen peroxide. Using fungal examination as the gold standard, compare the diagnostic efficacy of single and combined indicators. Results: The Nugent score of the observation group was significantly higher than that of the control group (P<0.05); The levels of leukocyte esterase and acetylglucosidase in the observation group were significantly higher than those in the control group, and the level of hydrogen peroxide was significantly lower than that in the control group (P<0.05); The sensitivity, specificity, positive predictive value, and negative predictive value of vaginal microbiota quantitative scoring combined with biochemical markers for diagnosing RVVC are all higher than those of a single indicator; As the severity of RVVC worsens, the vaginal microbiota quantification score and the levels of leukocyte esterase and acetylglucosidase gradually increase, while the level of hydrogen peroxide gradually decreases (P<0.05). Conclusion: The combination of vaginal microbiota quantitative scoring and biochemical markers can improve the diagnostic accuracy of RVVC, facilitate disease assessment, and provide important guidance for clinical diagnosis and treatment