Background:The most common cancer of the genital area among Indian women is cervical cancer. It accounts for 80% of all women with cervical cancer. Early detection of preinvasive disease and treatment of cervical intraepithelial neoplasia may improve patient outcomes. Cervical cancer is preventable due to its long preinvasive state, the anatomy of the cervix that allows re-examination, and the availability of good screening methods for preinvasive treatment of the disease. Aim & Objectives: To evaluate the relationship between Pap smear and colposcopy in the detection of cervical premalignant lesions and to investigate the role of colposcopy in the evaluation of abnormal cervical cytology and its relationship with cancer diagnosis. Material and Methods:80 women with abnormal pap smear participated in this hospital-based observational research which lasted for 12 months at Muzaffarnagar Medical College & Hospital in Muzaffarnagar, Uttar Pradesh. Chi square and t test were used in the statistical analysis of the data. Results:Mean age in our study was 41.7 years. Total 80 abnormal pap smear cases underwent into biopsy in which 40% ASCUS results into 17.5% nonspecific chronic cervicitis, 13.8% CIN I, 8.8% CIN II cases. 37.5% patient of LSIL results in to 17.5% nonspecific chronic cervicitis, 7.5% CIN I, 12.5% CIN II. 7.5% ASC-H cases results in 2.5% CIN I, 3.8% CIN III, 1.3% SCC. 15% HSIL results into 1.3% CIN II, 11.3% CIN III, 2.5% SCC. Conclusion: Colposcopy is better tool for the evaluation of women with abnormal Pap smears, unhealthy cervix, and seems to be more accurate in detecting CIN. Colposcopy eliminates the need for repeated follow up as in pap smear which has defined low sensitivity. Hence, colposcopy with biopsy should be incorporated in women with abnormal cervical cytology. Colposcopy using RCI (Reid Colposcopic index) has satisfactory diagnostic efficacy and the good correlation with histopathology makes it a valid tool in order to detect timely changes that precedes the cancer cervix.