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Background: Since the identification of HPV as the necessary cause of cervical cancer, knowledge of its natural history for cervical infection; genotypes, load and form, is essential to prevent and predict cervical carcinoma. A cross sectional study was conducted to see the natural history and genotypes of HPV in cervical neoplastic lesions. Materials and Methods: Two diagnostic modalities, IHC and PCR, were performed on 102 diagnosed cases of cervical premalignant and malignant lesions (Cervical Neoplastic Lesions: CNL) and lesions by histopathology. Results: Out of the102 cases there were 12, 44,40 and 6 cases of Squamous cell Papilloma(SCP), Squamous Cell Dysplasia(CD), Squamous Cell Carcinoma(SCC) and Adenocarcinoma(ADC) respectively. There were 82 CNL, which showed positive HPV reaction on IHC while 88 CNL showed presence of HPV (56/88:64% HPV-18 and 32/88:36% HPV-18) on PCR. There was significant association between the presence of HPV and p53 mutation among different CNL. There was no statistical difference in lesions with respect to positivity of HPV and P53 suggesting that the expression of this suppressor gene was affected by the presence of the HPV genome, p-value>0.05.IHC scoring of CNL was not significantly affected with HPV infection (p-value>0.05). The overall sensitivity, Specificity and accuracy of IHC against PCR was 93%,70,89% merits and demerits of each modality has also been given in detailed. The major mode of infection of HPV-16 was host nuclear integration (p:0.000) with different variant with predominant E-350G genotype(p:0.000). High Viral load was seen in infected cervical tissues. Conclusion: HPV-18&16 were detected;E-350 G genotype was most common form while predominant way of infection was host nuclear integration of HPV. The etiological involvement of HPV in the development of CNL was found because of high viral load and significant association with p53 protein expression with HPV infection. Citation Information: Cancer Prev Res 2011;4(10 Suppl):A115.