Cervical cancer despite being largely preventable, is still the leading cause of gyneacological cancer related death among females in developing countries. Population based cervical cytologic screening and early treatment of cervical cancer precursor lesions in a population with high level of awareness about cervical cancer and its screening reduce the morbidity and mortality associated with cervical cancer. The objective of this study was to determine the prevalence of cervical intraepithelial lesion and the factors influencing various patterns among women attending gyneacological clinic at UBTH. This was a prospective study involving four hundred and eighty five women consecutively selected among the women attending gynaecological clinic at UBTH, within the study period. The main outcome measure was increased proportion of women with Pap smear screening and cervical cancer awareness. The prevalence of cervical intraepithelial lesion in this study was 20.6%. A total of 216 (44.9%) of the women were aware of cervical cancer and only 32.4% were aware of cervical cancer screening while only 13.5% ever had at least a Pap smear testing Premalignant cervical lesion was significantly higher among women 30 years and older and lower socioeconomic class with a significant linear trend in each of these groups. High parity especially vaginal delivery, cigarette smoking and having had a previous Pap testing were each associated with increased risk of abnormal Pap smear. Previous contraceptive use especially intrauterine contraceptive device (IUCD) was associated with increased risk of cervical intraepithelial lesion. Condom offered some protection. First marriage before 20 years of age and lifetime partners in excess of four were associated with increased risk of abnormal Pap smear. Age at coitarche, age at first pregnancy, spouse smoking, type of gynaecological condition, cervical cancer and cervical cancer screening awareness did not significantly influence the pattern of Pap smear among the women