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Background: Cervical cancer is a major contributor to mortality and morbidity among women in low- and middleincome countries. Unlike other cancers, cervical cancer is preceded by a spectrum of cytomorphological changes called cervical intraepithelial neoplasia (CIN) for many years before developing into a frank malignancy. Objective: We aimed to detect the accuracy of naked eye (NE) visual inspection in early detection of cervical intraepithelial neoplasia. Patients and Methods: This cross sectional study was conducted at Obstetrics and Gynecology Outpatients Clinic and Pathology Department, Zagazig University Hospitals on 206 patients during the period from January 2021 to June 2021. Results: About 81% of patients had normal appearance cervix on NE examination. Visual naked eye inspection with acetic acid staining was negative in 41.3%, low threshold positive in 36.4% and high threshold positive occurred in 22.3%. There was significant association between presence or intensity of visual inspection with acetic acid (VIA) and nature of lesion. Within normal/benign lesion, 49.1%, 39.3% and 11.7% had negative, low threshold positive and high threshold positive respectively. Within CIN-1, 42.9%, 14.3% and 42.9% had negative, low threshold positive and high threshold positive respectively. Within CIN-2, 50% and 50% had low threshold positive and high threshold positive respectively. Within CIN -3, 35.7% and 64.3% had low threshold positive and high threshold positive respectively. Conclusion: Visual inspection with acetic acid (VIA) can be used as cervical cancer screening test especially in lowresource settings. [ABSTRACT FROM AUTHOR]