Introduction: Pregnancy causes various hormonal changes and also changes in the anatomy of a Woman cervix. Objective: The main objective of the study is to find the efficacy of PAP smear among pregnant women attending antenatal clinic. Methodology of the study: This prospective observational study was conducted at ESIC hospital,Gulbarga from November 2023 to April 2024. Data were collected from 100 pregnant females. Data collection was carried out by trained healthcare professionals under the supervision of a gynecologist. Eligible participants were identified during their routine antenatal visits. The participants were first briefed on the goals of the research and written consent was sought from them. Cervical cells were collected from each participant through a cytobrush and a PAP smear was done. Results: Data were collected from 100 women, the majority (75%) were between 18 and 30 years old, with 40% aged 18-25 years and 35% aged 26-30 years. Half of the participants were primigravida, while the other half were multigravida. In terms of pregnancy stage, 50% of the women were in their second trimester, 30% in the third trimester, and 20% in the first trimester, reflecting a diverse representation across different stages of pregnancy.10% of the women had atypical squamous cells of undetermined significance (ASCUS), while 6% were diagnosed with low-grade squamous intraepithelial lesions (LSIL). More concerning findings included 3% of women with high-grade squamous intraepithelial lesions (HSIL) and 1% diagnosed with squamous cell carcinoma, highlighting the importance of regular cervical screening during pregnancy. Conclusion: It is concluded that PAP smear screening is an essential component of antenatal care, effectively detecting cervical abnormalities among pregnant women.