Bacterial vaginosis is characterized by changes in the vaginal microbial community, and therapeutic options are limited for persistent or recurrent bacterial vaginosis. Lev-Sagie, Goldman-Wohl, Cohen et al. report the feasibility of vaginal microbiome transplantation (VMT) from healthy donors as treatment for patients suffering from symptomatic, intractable and recurrent bacterial vaginosis. Four of the five treated patients showed full long-term remission and one patient incomplete remission after VMT, which suggests that VMT might be beneficial in treating the condition. Samples from donors and VMT recipients were analysed using shotgun metagenomic sequencing, which revealed that four of five recipients exhibited substantial changes in the microbiome composition, which were more similar to that of the collective donor vaginal microbiome. Randomized, placebo-controlled trials are needed to determine efficacy of VMT and the possible associated risk factors.