Aim: To study the effects of cluster of differentiation 4 (CD4) level on abnormal cervical cytology in human immunodeficiency virus (HIV)-infected women who have not received highly active antiretroviral therapy (HAART). Materials and methods:Retrospective cross-sectional study was carried at Hatyai Hospital from October 1, 2010 to June 30, 2016. Medical records of 270 HIV-infected women who have not received HAART and have been screened for cervical cancer with Pap smear were reviewed. The CD4 level has been evaluated in all patients. Participants were divided into two groups: 135 patients with CD4 < 200 cells/µL (low CD4 group) and 135 patients with CD4 at least 200 cells/µL (high CD4 group). Statistical analysis was performed. Results:The prevalence of abnormal cervical cytology in HIVinfected women who have not received HAART was 25.9%. There was difference in prevalence of abnormal cervical cytology between low and high CD4 groups (37.8 vs 17.0%) with statistical significance (p = 0.001). Odds ratio was 2.60 (95% confidence interval: 1.47-4.61). Conclusion:The low CD4 level (CD4 < 200 cells/µL) in HIVinfected women who did not receive HAART increased risk of abnormal cytology of 2.6 folds, compared with high CD4 level (CD4 at least 200 cells/µL). The prevalence of abnormal cervical cyto logy in HIV-infected women who have not received HAART was 25.9%. Clinical significance:Human immunodeficiency virus infection is the significant risk factor of cervical cancer. The authors evaluated the effects of CD4 level on abnormal cervical cytology in women who have not received HAART.