Provided is a vehicle door opening and closing device that can increase a degree of freedom in disposing a door drive unit. The door opening and closing device includes a door drive unit that provides a link arm with a torque for rotating the link arm relative to a vehicle body. The door drive unit includes: a drive drum to be driven by an electric motor; a driven drum to be disposed at a distance from the drive drum; a cable that is wound onto the drive drum and the driven drum and transmit power from the drive drum to the driven drum; and a transmission unit that provides the link arm with the torque, based on power transmitted from the driven drum.