Introduction: As cervical cancer is the third most common cancer among women and ten percent of cervical cancer incidence among those 65 years and above, Pap smear is still relevant to be performed among older women. The aim of this study was to determine the determinants of Pap smear screening among older women in an urban setting. Methods: This cross-sectional study was conducted among 515 women aged 50 and above in two urban health centres in Gombak, Selangor. The sampling technique conducted was random systematic sampling. The independent variables were age, marital status, employment status, gynaecological history (family history of cervical cancer, menopause, hysterectomy), obstetric history (number of live births, ever had contraception), presence of chronic diseases (hypertension, Diabetes Mellitus, heart disease). Results: Only 202 (39.2%) out of 515 undergone Pap smear screening. An estimated 80.7% of them had their last Pap smear a year ago. The mean age of the respondents was 58.83± 7.05 years old and 77.3% had one and more comorbidities. The respondents preferred health care personnel as the source for the pap smear information compared to reading materials and internet. Married vs divorced (aOR=1.89,p=0.02); those with heart disease (aOR=0.32,p value=0.01; those with Diabetes Mellitus (aOR=0.57,p value=0.01; those who had hysterectomy (OR=2.89, p value=0.04) and those who had contraception (aOR=3.72, p value = <0.001) were significant determinants for undergoing Pap smear screening. Conclusion: The prevalence of Pap smear screening among older urban women is still low. Determinants identified can be used in enhancing the prevalence of performing Pap smear by organizing programmes via targeted groups. [ABSTRACT FROM AUTHOR]