The human papilloma virus has been shown to play a significant aetiological role in invasive cervical cancer. The changes caused by human papilloma virus can be evaluated using Pap smear. The discovery of Pap smears has led to an unprecedented dramatic decline in the incidence of cervical cancer over the past five decades. This has been the case in high income countries due to effective cervical cancer screening programmes. The effectiveness of this simple cost-effective tool has led to attemptsat improving the quality of the Pap smear sample as well as the processing technique in the laboratory. This has led to the introduction of Liquid based cytology, a technique slowly replacing conventional cytology in the world due to its advantages. Although initially thought to be more sensitive and specific than conventional cytology, recent studies suggest that there are no significant differences in this aspect. The main advantage is that Liquid based cytology is less likely to be unsatisfactory or limited. Liquid based cytology has also reduced the screening time leading to improved turn-around time. The specimen submitted for liquid based cytology can be used to perform further tests such as molecular and microbiological studies. The Pap smear still plays an integral part in cervical cancer screening, despite recent advances in detection of human Papilloma virus using molecular techniques. The implementation of cervical screening programmes in low and middle income countries will assist in reducing the mortality related to invasive cervical cancer.