Antifungal drugs used for the treatment of fungal infections have a high risk of drug-drug interactions and side effects (such as hepatotoxicity and cardiotoxicity). Therefore, the search for novel antifungal drugs continues. Azole antifungals are among the most preferred drug classes in the treatment of invasive and mucosal fungal infections. This group of drugs targets lanosterol 14α-demethylase, which is responsible for the synthesis of ergosterol in the structure of the fungal cell membrane. However, their use is limited, as they also interact with human cytochrome enzymes. Oteseconazole (VT-1161) is a new-generation antifungal drug class of tetrazole. It causes fewer drug-drug interactions and side effects, as it acts by selectively binding to the fungal cytochrome P450 51 (CYP51). Studies have also shown that VT-1161 is effective against fluconazole-resistant Candida albicans and Candida krusei, echinocandin-resistant Candida glabrata, dermatophytes, Cryptococcus, Rhizopus, and Coccidioides species. Candida vaginitis (CV) is an important problem with an increasing prevalence globally. VT-1161 is characterized by high oral bioavailability, a long plasma half-life (> 48 hours), and effective penetration into the vaginal mucosa. This review presents up-to-date information on the spectrum activity of oteseconazole and in vivo and in vitro data. Considering the limited treatment options for acute and recurrent CV, VT-1161 seems to be a safe and effective option.