Pelvic tension myalgia (PTM) is characterized by levator ani complex hypertonicity and vaginal pain upon contraction of pelvic musculature, attempted penetration, or internal examination. Standard treatment consists of specialized pelvic physiotherapy and psychotherapy, however, the most effective treatment has yet to be determined, and reports of comparative success rates are not available. Some women experience pain that hinders physiotherapy, and access to appropriately trained physiotherapists can be limited. Thus, an alternate or adjuvant treatment to optimize quality of care and symptom management is necessary. Off-label use of vaginal diazepam is based on clinic experience as publications evaluating intravaginal diazepam use for PTM are limited. The objective of this case series is to report the rate of clinical effectiveness of vaginally administered diazepam as a treatment for PTM. Additionally, dosage, frequency of administration, rate and nature of adverse events, and patient phenotype for which treatment may be most effective will be studied.