: The Papanicolaou (Pap) smear used worldwide for cervical screening was developed by Dr George Papanicolaou in 1940s. The Pap smear is a simple, safe and effective test to detect cervical cancer at an early stage.: To study the spectrum of lesions in cervical Pap smear based on The Bethesda System(TBS) 2014 and to determine frequency of premalignant and malignant lesions.: The present prospective study included 200 cases above 20 years of age. The cytological interpretation of smears were made according to TBS 2014. When there was difficulty in differentiating HSIL from other lesions p16 immunostaining was done and evaluated according to the criteria proposed by Wentzensen et al. : Chi – square test was used to see the association between different attributes. Statistical analysis was performed using SPSS version 22. P value <0.05 was considered significant.: The most common lesion was NILM with 175 cases (87.5%) followed by 7(3.5%) SCC, 4(2%) HSIL, 2(1%) cases each of ASCUS, AGC-NOS, LSIL and 1(0.5%) case of ASC-H. Among 200, 7(3.5%) cases were unsatisfactory for evaluation. The subjects were not uniformly distributed (P <0.001). The p16 marker was used in 6(3%) doubtful cases of HSIL among which 2(33.33%) cases were positive. Cervical Pap smear is a useful technique to detect the inflammatory, premalignant and malignant lesions of cervix which helps the clinician to plan further management.