Background: Malignancy of cervix is the major health burden in South Asia including Pakistan. PAP smear is the screening test for its early detection. To find out the specificity and sensitivity of the system called as Bethesda system, the correlation of cytological findings with histopathology,with histopathological examination as the golden standard.

Aim: To find out the cytological utility in diagnosing different pathologies of cervix, to assess and infer the epithelial lesions cases and to correlate cytology findings with its consequent follow-up biopsies.

Methods: This study was carried out taking 150 PAP smears of women coming to gynecological OPD ofShaikh Zayed Hospital Lahore from September 2020 to February 2021. There correlation with subsequent follow-up histology sections by using 2001 revised Bethesda System.Different factors analysis which were causing inconsistencies was done.

Results:The overall sensitivity of PAP smear is 86.94%, specificity 57.14%, positive predictive value 86.94 %, negative predictive value 57.14 % and accuracy 80% in detecting low/high grade lesions and malignancy.

Keywords: Bethesda system,Cervix cytology findings; Histopathological findings.