In India, the need exists for a scheme of selective screening for women at high risk of developing cervical carcinoma. In this study, the incidence of abnormal cervical cytology amongst 500 pregnant south Indian women (gravida 3, para 2 or more) who were booked under the Post Partum Programme of the Government of India was compared to that of 200 primi and second gravidas from the same out patient clinic population. Abnormal cytology was detected in 3.6% of the women in the study group which was significantly higher (P less than 0.05) than that in the control (0.5%), indicating that the former are at higher risk of developing cervical cancer. Within the study group, abnormal cytology was not found to correlate with increasing age and gravidity or with any clinical parameter. The study and follow up could be carried out using existing facilities and manpower. Using existing personnel involved in the Post Partum Programme, a follow up rate of 67% could be achieved from among women with abnormal cervical cytology. The cost-effectiveness of this scheme of selective screening is borne out by the extremely modest additional cost incurred.