The Pap smear has been recognized widely as the most effective cancer screening test in the history of medicine. It is widely believed that the use of this test has been responsible for the drastic reduction in the incidence and mortality of cervical cancer in the United States, Canada, and much of Western Europe in the last 50 years. Several adjuncts to the Pap smear including liquid based cytology, computer-assisted screening, human papilloma virus and molecular testing are discussed.