A 16-year-old girl presented with recurrent vulval abscesses as the only initial symptom of Crohn's disease without typical bowel problems. Initial treatment included local drainage and antibiotics, but the effect was limited. Targeted history revealed changes in bowel habits, blood tests confirmed a strong inflammatory response and positive fecal calprotectin. The diagnosis of Crohn's disease of the ileum was confirmed by imaging, endoscopic examination and pathology. Treatment included drainage, antibiotics, exclusive enteral nutrition, and steroid-free ustekinumab. The patient achieved clinical and mucosal remission. The case highlights the need for suspicion of Crohn's disease in recurrent vulvar abscesses in adolescents and a combination of tests for early diagnosis.