Aims and objectives: The present study was aimed to assess the sensitivity, specificity and predictive value of colposcopy as tool for early detection of premalignant lesions in unhealthy cervix at a tertiary care center, catering to both rural and urban population. Material and methods: The study is a prospective study comparing Pap smear and colposcopy for early diagnosis of cervical cancer, spans over one and a half year and was carried out in the Department of Obstetrics and gynecology, Mahatma Gandhi Medical College & Hospital, Jaipur. Results: For PAP, the calculated Sensitivity was 37.93% and the Specificity was 95.04%. The Positive predictive value was 64.71% and Negative predictive value was 86.47%. For colonoscopy, the calculated Sensitivity was 87.93% and the Specificity was 77.69%. The Positive predictive value was 48.57% and Negative predictive value was 96.41%. Discussion:Colposcopy was found to be useful in understanding the morphology of the cervical lesions, both of the neoplastic and the non-neo-plastic ones and this was very helpful in planning their management.