Vaginal bleeding in pre-pubertal girls is uncommon and can often be confused with the bleeding from the genital or urinary tract or from the anus. The paper reports the case of a 6-year-old girl with pollakiuria and “dark urine” without pain, which lasted for ten days. On the assumption of macrohematuria, initial evaluations to exclude nephro-urological causes of bleeding were performed and resulted negative. Finally, uroCT showed the presence of inhomogeneous material inside the vaginal lumen. Vaginoscopy enabled to ascertain the vaginal origin of the bleeding and to remove the foreign body: abundant toilet paper! Foreign bodies are the main cause of vaginal bleeding in pre-pubertal girls and toilet paper is the most frequent foreign body found. Vaginoscopy in sedation is an essential tool for diagnosis and treatment. According to literature, psychological evaluation should be offered in case of vaginal foreign body in children, because of possible association with emotional and behavioural problems.