AbstractBackground: Cervical cancer is the second most common type of cancer among women as per WHO, accounting for about 1, and 90,000 deaths annually. Conventional cervical cytology by pap smear is the most widely used cervical cancer screening test in the world. Aims and objectives: To find out efficacy of pap smear cytology in screening of cervical lesions and to correlate with histopathology, and to evaluate other factors associated with premalignant and malignant cervical lesions. Materials and Methods: This is a prospective clinical study, conducted on 130 women attending the gynaecology OPD of Father Muller Medical college hospital, who underwent pap smear and cervical biopsy for various reasons. Results: The mean age was 45.8+10.77 years, and maximum number of patients (43%) belonged to age 40-50 years. 26.9% belonged to post menopausal age group. 55.4% were multiparous with 3 or more children and were found to be at increased risk of precancerous and cancerous lesion of the cervix, though statistically not significant. Most of the patients presented with white discharge Per vaginum (38.5%). The sensitivity, specificity, positive predictive value and negative predictive value of pap smear in detecting premalignant and malignant lesions of the cervix was 72.40%, 88.10%, 63.60% and 91.80% respectively. Conclusion: Pap smear was found to be an effective tool in detecting early cervical lesions ans screebning of carcinoma cervix.