Introduction: Pap smear is the conventional screening procedure for cervical cancer. MLBC (Manual Liquid Based Cytology) has been developed as a cost effective alternative as it has a short screening time, better morphology andbackground while also providing residual material to test for HPV DNA.

Aim: To evaluate the diagnostic efficacy of MLBC and compare the morphological parameters with conventional PAP smear.

Materials and Methods: This is a prospective study comparing 50 cervical smears using Pap smear and MLBC by the split sample method. The smears were stained by Rapid Pap stain and reported using Bethesda System.

Results:  In MLBC 18 (36%) cases were reported as inadequate smear but none of the smears were inadequate in CS. By MLBC method 10(20%) cases showed inflammatory cells while CS showed inflammatory background in 31(62%) cases. MLBC preparations showed 2 (4%) cases of LSIL   while CS showed 2(4%) HSIL and 4(8%) LSIL. The interpretation of results revealed that there was a statistically significant difference between the two methods (P<0.001).

Conclusion: MLBC is better than CS in that it has uniform distribution, reduced cellular overlapping and a cleanbackground but it was inferior in detecting epithelial lesions. So, by improving the MLBC technique, its efficiency can be increased for use in low resource settings.