In a randomized study three methods of obtaining cells for Papanicolaou smears were tested: the classical Ayre spatula, the Ayre spatula plus the endocervical cytobrush and the cervexbrush. Endocervical cells were identified in 67.8% of smears obtained with the Ayre spatula alone, in 89.1% of smears obtained with the Ayre spatula plus the endocervical cytobrush and in 85.6% of smears obtained with the cervexbrush. The use of the Ayre spatula alone for obtaining cervical cells for Papanicolaou smears is discouraged.