The dermatologic examination of the pregnant woman with abnormal cervical cytology can be a challenge to the clinician. This article explores both the laboratory and clinical examinations and the special issues of each that are affected by pregnancy. The technique of obtaining an adequate Pap test as well as guidelines on managing the abnormal Pap result will be addressed. Normal and abnormal colposcopic findings are described with reasons why they may be more difficult to differentiate in pregnancy. As long as no invasive cancer is found, the pregnancy may proceed with continued surveillance. Postpartum regression rates of intraepithelial neoplasia are high.