A total of 104 pregnant patients with abnormal cervical cells were referred to the Dysplasia Clinic for evaluation and management by colposcopy. Seventy-one pregnant patients presenting with basal cell atypia on cytologic examination had colposcopically directed biopsy revealing 8.45% severe dysplasia and 1.41% carcinoma in situ. Cytologic study in 31 pregnant patients with basal cell dysplasia revealed severe dysplasia in 29% and carcinoma in situ in 12.9% of the colposcopic biopsies. Cervical cytology revealed carcinoma in situ in two patients. Directed biopsy in both cases revealed carcinoma in situ with one case of questionable microinvasion. Colposcopically observed normal and abnormal physiologic findings and the pregnant cervix, complications after conization during pregnancy, and the impact of colposcopy in the management of the cytologically abnormal cervix during pregnancy are discussed.