ynecologic cancers are staged according to the International Federation of Gynecology and Obstetrics (FIGO) system (1). Although a parallel TNM system for gynecologic cancers has been described by the American Joint Committee on Cancer, the FIGO system continues to predominate worldwide in clinical practice and for cancer database reporting (2). The first staging system put forth by FIGO around the turn of the 20th century applied to carcinoma of the uterine cervix, at the time the most common cancer among women in the developed world (3). The most recent revision of the FIGO staging system was announced in 2018 (Table 1). Whereas FIGO staging of most gynecologic cancers relies on surgery and pathologic analysis, uterine cervical cancer is unusual among the gynecologic cancers in that it is staged clinically with pelvic examination, often under anesthesia with bladder cystoscopy and colposcopy, in combination with imaging. Preceding versions of the staging system included imaging with chest and skeletal radiography, intravenous pyelography, and barium enema (4-6). These low-technology choices reflected the demographic reality that nearly 85% of invasive cervical cancer is diagnosed in low-resource settings where advanced imaging modalities are unavailable. Staging according to the old systems (ie, FIGO cervical staging systems from 1999, 2009, and 2014) was inaccurate, with 20%-40% of stage IB-IIIB cancers understaged and up to 64% of stage IIIB cancers overstaged (7-9). Older systems did not include assessment of lymph node metastases, an important determinant for prognosis and treatment planning. Moreover, radical trachelectomy, an emerging fertility-preserving technique in which the uterine corpus is anastomosed to the vagina to treat the many women diagnosed during their reproductive years, was not a consideration with these older systems. To compensate for these shortfalls, treatment planning for invasive cervical cancer in much of the developed world has included modern cross-sectional and functional imaging such as CT, MRI, and fluorine 18 fluorodeoxyglucose, or FDG, PET (10,11). Such pretreatment imaging spared many women the particularly toxic combination of surgery, followed by concurrent chemotherapy and radiation therapy. Instead, they are triaged to one or the other curative, and far less morbid, options (12). The revisions introduced in the 2018 FIGO staging system are intended to address the gap between the staging formalism and ongoing clinical practice and to explicitly acknowledge the role that advanced imaging has come to play in the care of women with invasive uterine cervical cancer (13). In this article, we review the 2018 FIGO staging system for cervical cancer and the new additions relevant to radiologists. Imaging modalities for staging in a range of high-to low-resource practice settings are presented. The standards for image acquisition and interpretation are summarized with cases illustrating potential pitfalls. Finally, we describe how the recommended imaging choices can be directly a...