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A Chlamydia diagnostic service has been established as part of a cytology laboratory, combining prediction of possible infection by routine cytology with definitive testing by immunofluorescence. The first 10 mo of operation have had good clinician acceptance with 527 specimens submitted and 128 reported as positive (24.3%). Routine cytology was more accurate in predicting chlamydial infection than was clinical evaluation (32.8% of cytologically suspected cases were positive versus 20.2% of clinically suspected cases); however, both failed to identify many infected women. The patient selection for testing must be improved since only about 22% of infected women in our population were tested. Nevertheless, the service identified a large number of patients infected with an important sexually transmitted pathogen. Chlamydial diagnosis has become a major component of the laboratory's workload and has been cost-effective.