Bacterial vaginosis (BV) is a condition consisting of mucosal inflammation, Gram negative anaerobic bacteria colonizing the vagina at the expense of lactobacilli, elevated pH >4.5, and in some cases odor and discharge. In this randomized, double-blind, placebo controlled trial, 125 premenopausal women diagnosed with BV by clinical presence of vaginal irritation, discharge and ‘fishy’ odor, and by Nugent criteria and detection of sialidase enzyme, were enrolled. The subjects were given a single oral dose of metronidazole (500mg) twice daily from days 1-7, plus oral Lactobacillus rhamnosus GR-1 (2.5x109) and L. reuteri RC-14 (2.5x109) or placebo twice daily from days 1-30. Primary outcome was cure of BV as determined by Normal Nugent score, negative sialidase test and no symptoms or signs of BV at day 30. A total of 106 subjects returned for 30 day follow-up, of which 88% were cured in the antibiotic/probiotic group compared to 40% in the antibiotic/placebo group (p<0.001). Of the remaining subjects, 30% subjects in the placebo group and none in the probiotic group had BV, while 30% in the placebo and 12% in the probiotic group fell into the Intermediate category based upon Nugent score, sialidase result and clinical findings. High counts of Lactobacillus sp. (>105CFU/ml) were recovered from the vagina of 96% probiotic treated subjects compared to 53% controls at day 30. In summary, this study showed efficacious use of lactobacilli and antibiotic in the eradication of BV in black African women.