|Objective: The aim of this study is to compare and investigate the histological outcomes between premenopause and post-menopausal women with report of cervical cytological abnormality.Methods: A comparison of cervical cytological results of 501 pre-menopausal women and 135 post-menopausal women between 20-83 years from January 2010 to April 2018 was performed for presence of cytological abnormalities.Results: The prevalence of cytological abnormality was 92.3% ; ASCUS, LSIL, ASCH, and HSIL was 13.3%, 14.1%, 10.3% and 54.4%. Cytological abnormalities were similar in premenopausal women in comparision to postmenopausal women(92.6% vs. 91.3%). However, the incidence of histologically confirmed cervical cytological abnormality was significantly higher in premenopausal women(63%) than postmenopausal women(44.6%). Colposcopic biopsies were performed on 70 patients(premenopausal n=58 vs. postmenopausal n=12) who had a smear result of ASCUS; 6 patients(10.3%) had chronic cervicitis or atrophic changes, 5(8.6%) returned to LSIL, and 29(50%) returned to HSIL in the premenopausal group. In contrast, 5(41.6%) patients were diagnosed with chronic cervicitis or atrophic changes and 2(16.6%) patients with LSIL, and 3(25%) patients with HSIL in postmenopausal group. Biopsy results of 74 patients(premenopausal n=53 vs. postmenopausal n=21) with LSIL revealed chronic cervicitis in 13 patients(24.5%) and HSIL in 24 patient(45.2%) in premenopausal group. In contrast, 6(28.5%) patients were detected to be chronic cervicitis or atrophic changes and 6(28.5%) were detected as HSIL in postmenopausal group.Conclusion: This study showed significant difference in correlation of cytology and histology results from premenopausal groups and postmenopausal groups with cervical cytology abnormality. We think that since cytological results in postmenopausal women have low sensitivity, follow up pap smear with high risk HPV testing would be a more conservative management and appropriate than immediate colposcopic biopsy.