A typical squamous cells of undetermined significance (ASC-US) carry the lowest risk of invasive cervical cancer among the other abnormal cervical cytology. Early detection of premalignant conditions following abnormal Pap smear results helps significantly in the prevention and early management of cervical dysplasia; hence, in the reduction in mortality and morbidity of cervical cancer. To determine the prevalence of premalignant pathology, cervical intraepithelial neoplasia (CIN), associated with ASC-US Pap smear results in Saudi Arabian women. The results would help to establish the importance of following ASCUS Pap results with HPV testing. It would also demonstrate the role of ASCUS cytology in predicting cervical intraepithelial neoplasia 1, 2 and 3. A retrospective cross-sectional study was carried to evaluate all ASC-US pap smears, and this was followed by colposcopic-directed biopsy in the period between January 2013 and December 2015. Histopathologic findings of CIN1, 2 and 3 after single or repeated ASC-US results were obtained and included in the study. The majority of ASC-US cases were in premenopausal women, particularly those below the age of 40 years. It was found that 3.9% of colposcopy- directed biopsies results were positive for CIN1 and 4.6% showed koilocytosis. ASC-US, particularly CIN1, carry a low risk of cervical dysplasia and cancer.
 

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