Cytologic screening is an important diagnostic tool used to detect precancerous and cancerous lesions of the cervix. We studied the prevalence of cervical abnormalities, based on Pap smear results, in patients at the Outpatient Adolescent Clinic at West Virginia University. We found a high incidence of overall intraepithelial cell pathology (24%) in this group with 2.4% high grade and 9.9% low-grade lesions. These findings show that major cervical pathology is present in this age group. Furthermore, repeat smears at intervals of < one year were performed on 317 patients. Of these repeat smears, 7% changed from normal to abnormal in this period. Sexually active adolescent females should have Pap smears at least annually to detect abnormalities that may otherwise not be detected until they are more advanced and difficult to manage. Higher risk adolescents may need semiannual screening.