Objective: Our purpose was to examine the correlation between colposcopic and histologic findings in patients who have undergone loop electrosurgical excision of the cervix (LEEP) for high-grade dysplasia on cytology without prior colposcopically directed biopsy. Study Design: A retrospective review was performed of all patients who underwent LEEP for high-grade squamous intraepithelial lesion (HGSIL) on Papanicolaou (Pap) smear without a prior cervical biopsy over a 17-month period. We correlated the histologic result with colposcopic findings at the time of LEEP. Results: Of 104 patients undergoing LEEP, 63 patients (61%) had cervical intraepithelial neoplasia (CIN) grade 2 or greater. Thirty-four (54%) of these 63 patients with histologically proved high-grade dysplasia had a normal or low-grade colposcopic examination. There were 10 patients with CIN 1 to CIN 1-2 and 1 patient with microinvasive squamous cell carcinoma. Conclusion: Despite lack of correlation between colposcopic and histologic results, HGSIL on Pap smear is an appropriate indication for LEEP. (Am J Obstet Gynecol 2003;188:1180-2.)