Background: The fourth most frequent type of cancer and a major cause of death is cervical cancer. Because of its lengthy pre-invasive course, pap smears can be used as a routine screening tool to identify it. Aim: utilizing the Pap test to identify cervical dysplasia and colposcopy to confirm the diagnosis, as a way of prevention and early detection of premalignant cervical cancer lesions. Methods: 60 women on contraceptive pills (the combined one) undergo treatment in outpatient clinics of the hospital of Zagazig University. We perform PAP smear and colposcopic examination if there are abnormal findings to all involved patients. Results: 43.3% of cases were normal, 38.3% showed inflammatory changes, and 18.3% were abnormal. Among the abnormal results, 3.3% were classified as Low-Grade Squamous Intraepithelial Lesion (LG SIL), 11.7% were identified as Atypical Squamous Cells of Undetermined Significance (ASCUS), and 3.3% showed both ASCUS and atypical endocervical glands. There’s no relation between the delivery method and PAP outcomes (p-value 0.49). Parity shows no significant association with abnormal PAP (P = 0.43). Prolonged use of OCP is significantly associated with abnormal PAP (P =0 .0022) Conclusion: Abnormal cytology is significantly related with long-term oral contraceptive pill use.