Background: Cervical malignancy is the major health burden in India. For detection in early stage, the screening test is PAP smear. To check the sensitivity and specificity of Bethesda system, the cytological findings have to be correlated with histology considering histopathology as gold standard. Objective: To study usefulness of cytology in detecting various cervical lesions, to evaluate and interpret the cases of epithelial lesions and correlation of cytological findings with subsequent follow-up histology sections. Materials and Methods: A retrospective review of PAP smears in Dhiraj General Hospital in the period from May 2015 to September 2016. They were correlated with corresponding follow-up biopsies using revised 2001 Bethesda System. Analysis of different factors causing discrepancies was done. Results: The PAP smear has overall sensitivity of 86.04%, specificity 42.85%, positive predictive value 90.24 %, negative predictive value 33.33 % and accuracy 80% in detecting low/high grade lesions and malignancy.