Background: Papanicolaou cytology tests of the vaginal vault are a means of detecting recurrent invasive or preinvasive disease of the lower female genital tract in women who no longer have a cervix. Vault cytology testing may also be undertaken on asymptomatic women who had no abnormal cervical pathology at the time of hysterectomy, or prior to surgery, to screen for the recurrence of any neoplasm or to detect the occurrence of primary neopalsm. This study was undertaken to assess the utility of vault cytology in the follow-up of hysterectomized women. Methodology: All vaginal vault smears for cytological examination were collected during the period from May 2022 to November 2023 at Saveetha Medical College and Hospital. The women presenting with various benign conditions had been treated by hysterectomy alone while cases of cervical cancer or other gynecologic malignancies were treated with surgery, radiation, and chemotherapy in different combinations depending upon the stage of the tumor, the operative risk, and the patient’s preference. The smears were stained by the Papanicolaou staining method and reported under the following cytological categories: inconclusive, benign, infectious, and malignant.