Background: By simple Papanicolaou smear (Pap) screening test cervical cancer and its precursor lesions can be detected and treated early. The present study was conducted to assess spectrum of changes seen in Pap smears in patients presenting to Gynae Outpatient Department in a Tertiary care hospital in Punjab. Material & methods: The present study was conducted at a tertiary care hospital in Punjab from August 2021 to February 2023 and a total of 1266 patients were included, who reported to GianSagar Medical College and hospital, Ramnagar, Rajpura, Punjab. Cervical smears were taken and stained with Papanicolaou stain. Smears were reported as per the Bethesda system 2014. Results: In the present study, out of 1266 cases, 3.31% cases were Unsatisfactory, 87.99% (n=1114) cases were negative for intraepithelial lesion/malignancy and 8.68% (n=110) cases showed epithelial cell abnormality. In negative for intraepithelial lesion cases, 0.86% cases were reported as atrophic smears, majority were inflammatory smears (78.43%) and the remaining 8.68% showed no other changes. Out of the various epithelial cell abnormalities reported, ASCUS was seen in 5.45% cases, AGUS in 0.07%, HSIL in 1.18%, LSIL in 0.39%, ASC-H in 1.18% and squamous cell carcinoma in 0.39% cases. Conclusion: The present study concluded that majority of the cases (87.99%) comprised of inflammatory smears and 8.68% cases showedpresence of epithelial cell abnormality. Screening of pap smear is a low cost effectiveprocedure to help women of low socioeconomic status in screening and diagnosing various cervical lesions. Thus, it is helpful in reducing overall morbidity and mortality in women.