RATIONALE AND OBJECTIVES. Distant metastasis of cervical cancer, once considered rather uncommon, has become more common in recent years because of longer survival of the patients. The purpose of this study is to evaluate the radiographic patterns of its thoracic metastases correlating with the pathways of metastatic tumor spread.methods. The conventional radiographs (62 cases), thoracic computed tomography images (20 cases), and medical records of 62 patients with advanced squamous ceil carcinoma of the uterine cervix with thoracic metastases who died of extensive disease and its complications during a recent 5–year period were reviewed retrospectively.results and conclusions. In addition to the most typical pattern of multiple pulmonary nodules (71%), mediastinal and hilar lymphadenopathy (32%) and pleural metastases (27%) were frequently observed. Rare findings included bone metastases (6%), endobronchial obstruction (5%), and lym-phangitic carcinomatosis (3%). The mechanisms of metastasis in relation to the above manifestations are proposed. © 1995, Lippincott-Raven Publishers.