The American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines for the management of women with abnormal cervical screening test results is a powerful, evidence-based document representing an advance in the consistent treatment of women with cervical abnormalities. Nevertheless, the complexity of the guidelines is an outstanding issue, compliance with the guidelines is problematic in some areas, and there is a growing recognition of the deficiencies of colposcopy. In light of these challenges, the cytopathology community has an opportunity to play an active role in integrating data, defining risk, and recommending proper management for women screened for cervical cancer.