This document briefly captures the development of cytopathology at the Hospital of the University of Pennsylvania (HUP) in Philadelphia PA; the first medical school and the teaching hospital in the Country. Literature suggests that cells from malignancy have been described since early 1830s. While earlier accounts are not available, in the year 1895, 9th edition of the book written by Professor of Pathology, Dr. Tyson of the University of Pennsylvania describes urothelial cell morphology. It is also noted that both gynecologic as well as non-gynecologic cytopathology is routinely being practiced at this Institution since 1949. Following the administrative consolidation of the department of pathology and laboratory medicine, a separate section of cytopathology within the department was established. Growing academic and clinical enterprises of HUP have resulted in establishment of Ruth and Raymond Perelman Center for Advanced Medicine (PeCAM) in the year 2010. Currently, the section has seven full time cytopathologists. It has patented a cart for onsite cytopathology interpretation, offers state of the art cytopathology services including onsite interpretation and reporting, point of care specimen triaging, molecular cytopathology testing as well as hosts telecytopathology systems within the Health System and training program.