A total of 95 patients had 150 parametrial biopsies with all patients receiving follow-up for a period of 2-10 yr. The analysis of these patients revealed that needle biopsy was successful in differentiating between recurrent, persistent, and/or radiation changes in 97% of the patients. The biopsy was helpful in planning definitive treatment and follow-up in 93% of the patients with minimal complications. This study suggests that parametrial needle biopsy is very useful for diagnosis of persistent and/or recurrent carcinoma of the pelvis and carries minimal complications.