Background: Screening for cervical cancer using visual inspection with acetic acid (VIA) has been advocated by WHO as a suitable, low cost and feasible alternative modality for control of cervical cancer in low resource setting. The aim of the study was to assess cervical cancer screening for high risk women using acetic acid and implement the plan of nursing action. A cross-sectional design was carried out in the Gynecological OPD at Zagazig University Hospitals. A purposive sample of 100 females was required to estimate sensitivity and specificity of acetic acid in identifying pre malignant epithelial cell changes of the cervix. The tools used for data collection were; a structured interview sheet, clinical assessment sheet and the plan for nursing action. The results revealed that, women at risk for cervical cancer were more likely to be >30 years and more, their age of marriage was <20 years, had positive family history of cancer. They were also multipara, had repeated cervical laceration, exposed to STIs especially chlamydia and menorrhagia was present in 29.0% of them. Meanwhile post-coital bleeding was reported by 19.0% of the participants. Positive result for premalignant cervical lesion was 26.0% for VIA. Sensitivity and specificity of VIA were found to be 100% and 89.16% respectively. The accuracy of VIA was 91.0% which means that VIA test was more accurate. It can be concluded that VIA can effectively identify more cases of cervical intraepithelial neoplasia. It has been proven to achieve high sensitivity with an acceptable specificity. VIA test offers hope for universal screening as an alternate method for low resource setting. It is recommended that; VIA should be actively advocated to improve detection rate of cervical lesions so that it should be performed in all the women attending outpatient gynecological clinics.