OBJECTIVE: Bacterial vaginosis (BV) is an infection characterized by a change in the micro flora of the vagina. BV has been associated with adverse pregnancy outcomes and increased risk of acquisitions of sexually transmitted diseases (STD). In this study, we sought to determine the association of douching and other behavioral risk factors in relation to BV. METHODS: This cross-sectional study was carried out among 1252 women attending four family planning clinics in Lima, Peru in 1997. Structured questionnaire was used to collect information on socio-demographic and lifestyle characteristics of women. BV was diagnosed by the Nugent's score. Logistic regression procedures were employed to estimate adjusted odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: Mean age of participants was 25.1 ± 4.7 and 23.4% had more than 11 years of formal education. The prevalence of BV was 20.1% and significantly associated with a number of behavioral risk factors. Women who practice douching were 2.28-times (OR=2.28; 95% CI: 1.0-5.0) more likely to have BV compared with those who didn't practice. Having two or more sexual partners was also associated with a two folds (OR=2.0; 95% CI: 1.2-3.5) increased risk of BV. Those who started sexual intercourse at a younger age were 1.4-times (OR=1.0-1.9) more likely to have BV. CONCLUSION AND IMPLICATION: Douching is a risk factors associated with BV among Peruvian women. Programs aimed at women's health must address the adverse health outcomes associated with douching. Future population based studies that investigate associations of douching and adverse reproductive and gynecologic health outcomes need to be conducted.