Cervical cancer poses a significant global health challenge, with diverse causative factors. According to the National Cancer Registry Programme's data for Tamil Nadu, the estimated prevalence of cervical cancer stood at 36,014 cases, with 8,534 new cases reported in 2023. While various studies have investigated cervical cytology patterns and associated factors, research specific to particular geographic areas and demographic groups is crucial to bridge knowledge gaps and gather context-specific data. In this study, 300 women attending a hospital outpatient department in Chennai were selected. Pap smear samples were collected using Ayre’s spatulaand fixed on a glass slide and slide reporting was done according to the New Bethesda III classification system for Reporting cervical cytology. The majority exhibited normal cervical cytology (92%), with bacterial vaginosis, Trichomonas vaginalis, and Candidiasis being common. Atypical squamous cells of undetermined significance (ASCUS) were the most frequent epithelial cell abnormality. Clinical examinations revealed various cervical abnormalities, including chronic cervicitis, cervical erosion, and ulcerative cervix. Age emerged as a significant factor influencing abnormal cervical cytology prevalence, particularly in the 41-50 age groups. The high prevalence of abnormal epithelial cell lesions underscores the importance of regular cervical cancer screening to detect precancerous stages early and prevent invasive cancer development. This study, conducted among women aged 30 to 80 in Chennai, provides valuable insights into cervical health in this population, potentially informing future research and clinical practices in the region.