Despite the technical advances in radiotherapeusis, the fact is established that approximately 20 per cent of clinical Stage I and 30 per cent of clinical Stage II cases of cervical carcinoma are not cured by radiation therapy (1). The basic causes of failure in the early stages of this disease could be, first, a radioresistant type of tumor; secondly, a vaguely understood biologic difference of the tissues of the host; thirdly, an error in the clinical estimate of the actual extension of the disease. Within the past decade, accruing observations question the position of radiation as the exclusive therapeutic approach. The bugbear of high operative mortality associated with the formidable procedures in the past has disappeared. Unfortunately, it is impossible to compare statistics, for the large series of the past did not have the benefits of the recent advances in surgery, and the present series are too recent to permit intelligent appraisal. Another difficulty is the invalidity of the comparison of cases in the several clinical stages. Though the establishment of such classifications is invaluable, the error of clinical judgment is approximately 25 per cent when the true estimate is established at surgery or autopsy. The increased interest in the preclinical stage of cervical carcinoma, aided by the development of the cytologic examination of the exfoliated cells, has resulted in the advocacy of surgery as the method of choice in this type of case. The success of surgery in the so-called carcinoma in situ, or clinical Stage 0 case, is entirely dependent on the thoroughness of the preoperative study, i.e., the correct estimate of the clinical stage of the disease. There is no extension of the lesion in these cases, despite occasional reports to the contrary. Multiple-block examination of the cervices preoperatively diagnosed as carcinoma in situ occasionally discloses invasive lesions distant to the site of the original biopsy. In such cases, instead of a Stage 0, we are dealing with a Stage I or possibly Stage II neoplasm. For the Stage 0 cases, we subscribe to the surgical procedure advocated by Te-Linde (Fig. 1, A). This is a radical total hysterectomy. Since many of these cases are in a younger age group than those with the more extensive type of lesion, the ovaries are not routinely removed. From the illustration, it will be seen that very little of the parametrium and none of the lymph nodes are removed, but if the clinical estimate of the disease is correct, the cure is certain. Unfortunately, too many benign lesions of the cervix are uncritically interpreted as carcinoma in situ and too many young women are receiving either surgery or radiation without proved indications. For those carefully selected cases in the Stage I and early Stage II groups, Meigs (Fig. 1, B) performs a radical total hysterectomy, with removal of the regional lymph nodes. Despite his remarkably low mortality rate, this is not a simple operation.