Context: Papanicolaou smear or Pap test is a widely accepted screening test to detect carcinoma cervix in early stages. In developed counties like United Kingdom, incidence of carcinoma cervix is decreasing by 3.5% every year mainly because of well-organised screening programmes. However, this is not true in India where incidence and mortality due to cervical cancer is increasing every year. Aims: The present study aims at evaluating the diagnostic accuracy of Pap smear in abnormal cervical smears and to analyse the factors responsible for discrepant cases. Methods: The histological diagnoses were correlated with cytology diagnoses and diagnostic accuracy of cytology was calculated considering histological diagnosis as gold standard. Results: Pap smear showed sensitivity of 88.23%, specificity of 92.5%, positive predictive value of 71.42% and diagnostic accuracy of 91.7% in the present study. Conclusion: The regular screening of women by Pap smear is a cost-effective method for early detection of premalignant and malignant cervical lesions and secondary prevention of carcinoma cervix.