A review of 584 consecutive cases of conizations performed over a 15-year period showed that 320 patients (54.8%) had conizations because of the presence of neoplastic cells in the endocervical curettings. Of these patients, 268 (83.4%) had cervical intraepithelial neoplasia of various grades on conization, and 12 (3.6%) had microinvasive cancer. The remaining 40 patients had normal cervical epithelium. One hundred seven (18.3%) patients had conization because of cytological smear and colposcopy discrepancy. Seventy-six (71.0%) patients in this category had cervical intraepithelial neoplasia. Two (2.0%) had superficially invasive cancer; the remaining 29 patients had normal cervical histology. Sixty-seven (11.5%) had conizations because of unsatisfactory colposcopic evaluations. This review indicates that although conization is less frequently performed, it is still a useful tool in the management of patients with abnormal cytology in whom colposcopy evaluation cannot rule out invasive cancer.