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Background: Cervical cancer cases in India account for one-fourth of the worldwide burden. Colposcopy is used to evaluate the cervix of women with abnormal screening test results. For standardized reporting, various scores were introduced of those, Reid Colposcopic Index (RCI) and Swede score are the most commonly used. Aims and Objectives: This study is undertaken to determine the diagnostic efficacy and clinical relevance of the newly introduced MSCI and compare MSCI and Modified Reid Index. Results: 225 women out of 237 were analyzed. MSCI score 9 perform best for colposcopic diagnosis of CIN 2 or higher lesions. The sensitivity, specificity, PPV, and NPV for threshold score 9 for CIN 2 or higher lesions were 94.92 %, 67.88 %, 51.38 %, and 97.39 % respectively. Modified Reid Index threshold 3 performed best for the detection of CIN 2 or higher lesions with a sensitivity, specificity, PPV, and NPV of 84.75 %, 44.85 %, 35.46 %, and 89.16 % respectively. On comparing the area under the curve (AUC) for MSCI and MRI, we found that the difference between the AUC of MSCI (0.854) and Modified Reid Index (0.657) was significant (P < 0.05). Conclusion: MSCI performs better than the modified reid index for the diagnosis of both HGL and LGL or higher. Also, the omission of impractical measurements and inclusion of easier and more practical parameters than the Swede score or Modified Reid Index makes MSCI a simple and effective screening tool