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Objective : This study aims to assess the immediate risk of cervical intraepithelial neoplasia grade (CIN)3+ lesions in women with abnormal cervical glandular cytology. Methods : A total of 403 women with abnormal cervical glandular cytology who underwent simultaneous HPV genotyping and cervical biopsy at the Zhejiang University School of Medicine Women's Hospital, China, between 2016 and 2020, were included in this study. The probability of CIN3+ lesions among women in each group was further analyzed. Results : Subsequently, 26.8% of women with abnormal cervical glandular cytology were diagnosed with CIN3+ lesions. The immediate risk of CIN3+ lesions in the atypical glandular cells, not otherwise specified (AGC-NOS), AGC-favor neoplasia (AGC-N), adenocarcinoma in situ (AIS), and adenocarcinoma (AC) groups were 12.7%, 55.7%, 88.9%, and 92.0%, respectively. The immediate risk of CIN3+ lesions in the AGC-NOS group was significantly lower than in any other groups. The positive rates of hrHPV in the AGC-NOS, AGC-N, AIS, and AC groups were 26.4%, 68.6%, 66.7%, and 56.0%, respectively. The prevalence of CIN3+ in the HPV-16 or 18/45 positive group was significantly higher than in the group of other 11 types positive and hrHPV negative group. Notably, women under 30 years old with AGC-NOS had a low risk of CIN3+ lesions (2.4%). When considering HPV status, the immediate risk of CIN3+ lesions in HPV-negative women was 0.0%. Conclusion : hrHPV genotype and age are valuable indicators to assess the risk of CIN3+ in women with abnormal cervical glandular cytology. Women under 30 years old with AGC-NOS/HPV-negative may have the opportunity to delay colposcopy if appropriate., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)