Background: Papanicolaou (PAP) smear is a simple, non invasive and cost effective method for detection of precancerous changes in the cervix. It is effectively used as a screening tool in cervical cancer screening program to identify precancerous lesions so that treatment can be started promptly and thus development of invasive cancer can be prevented. Aim: To study the correlation between PAP smear and cervical biopsy in malignant and non malignant lesions of cervix. Materials and methods: Prospective cross sectional study was conducted in a tertiary care hospital in Chennai. It included all cases between September 2012 and September 2017 in which both PAP smear and cervical biopsy were done. Cyto-histopathological correlation was done. Results: Out of the 377 cases, on PAP smears 85% of cases were reported as inflammatory smears. Premalignant lesions like LSIL and HSIL were reported in 6.1 % and 4.5% of cases respectively.0.7% of cases were directly diagnosed as SCC. 3.1% of cases were reported as ASCUS. Cytohistopathological correlation was done. Sensitivity in the present study was 81.3%, Specificity was 92%. Positive predictive value and negative predictive value were 77.6% and 86.5% respectively. Diagnostic accuracy of Pap smear in the present study was 84.5%