BACKGROUND Effective cytology based screening has successfully reduced the incidence of cervical cancer in developed countries by the detection and treatment of premalignant cervical lesions. In developing countries however, several challenges hinder the effective implementation of such services. Hence the need to validate alternative screening method likes VIA in low resource settings. OBJECTIVES To compare the sensitivity and specificity of visual inspection with acetic acid VIA relative to pap smear (cytology) in detecting squamous intraepithelial lesions of the cervix METHODOLOGY This is a cross sectional descriptive study of two hundred women which was conducted in UMTH between November 2013 and December 2013. Eligible women (those that met the selection criteria) attending all the clinics in the department of Obstetrics and gynaecology were serially recruited. Cytology then VIA was done on each participant at the same time.