Screening for cervical cancer is often considered the success story for cancer screening in the United States. However, much room for improvement still exists. For example, experts have yet to establish the best follow-up strategy for women with an abnormal Papanicolaou test and high-risk human papillomavirus (HPV) followed by a normal colposcopy or biopsy that is negative for cervical intraepithelial neoplasia. The incorporation of HPV testing has allowed the development of a more sensitive and cost-efficient strategy. This article presents a brief overview of related guidelines and current modalities, and reviews selected studies. Finally, future directions and a possible schema for clinical management of these patients are included. © Journal of the National Comprehensive Cancer Network.