Pap test is widely used both as a screening test in asymptomatic population and in the follow-up of patients with cervical carcinomas. The objective of the study was to evaluate cervical smear findings in the West Bank and to assess the need for cervical screening program in Palestine. Methods: This retrospective study was performed at two private laboratories in Nablus and Ramallah, in the West Bank/ Palestine. Cervical smears over a period of 5 years (2003-2007) taken from 239 women referred either for a check-up or with vaginal discharge were reviewed at two Pathology laboratories in the West Bank. All smears were fixed with 96% alcohol, stained with Papanicolaou stain and screened microscopically by a pathologist. Bethesda system definition of morphology was used. Results: Of the 239 smears, the majority of cases (59%) showed non- specific inflammation while cervical dysplastic changes were uncommon; 11 cases (4.60%) were classified as Atypical Squamous Cells of Undetermined Significance (ASCUS), 1 case (0.42%) was Low-grade Squamous Intraepithelial Lesion (LGSIL), however High-grade Squamous Intraepithelial Lesion (HGSIL) and cervical carcinoma were not found. Conclusion: Our findings are in agreement with Jordanian study which reveals low incidence of cervical precursor lesions, there aggressive screening program is not a priority or recommended in Palestine at this time. We should concentrate on education and awareness of Palestinian women to risk factors for cervical cancer.