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Abstract: Objective:: The purpose of this study was to evaluate a conservative cold-knife section technique for treatment of cervical intraepithelial neoplasia (CIN). This procedure can be adapted to patient age, preservation of childbearing potential and extent of dysplasia. Design:: Prospective study. Setting:: Gynecological Oncology Department in French Public Hospital. Population:: A total of 460 women treated for CIN between 1985 and 1999 were included. Methods:: A conservative cold-knife cervical section followed by blanket suture reconstruction was used in all cases. Main outcome measures:: Immediate operative results, recurrence and reproductive function were assessed. Results:: The mean length of the cervical specimen was 11.4mm (range, 4–22mm). Mean specimen thickness was strongly correlated with age: 10.6±4.1mm in women <40 years versus 12.1 in women >40 years; p <0.001. Complete excision was achieved in 395 cases (85.8%). Post-operative bleeding was observed in 5 cases (1.1%). The mean duration of follow-up was 62 months (range, 12.3–156.5 months). Recurrences developed in 26 patients (6.6%) including CIN 1 in 9 cases, CIN 2 in 9 and CIN 3 in 8. No patient developed carcinoma. The actuarial risk of recurrence was 2.4% (±S.D., 0.9) at 24 months and 7.8% (±S.D., 1.9) at 60 months. A total of 52 pregnancies were observed in 39 patients. No case of de novo infertility was reported post-operatively. Amenorrhea was noted in 1 patient (0.1%) and dysmenorrhea in 1 patient (0.1%). Conclusions:: This conservative cold-knife section technique is effective for treatment of CIN with low morbidity and little adverse effect on childbearing potential. Exposure of the squamocolumnar junction (SCJ) greatly facilitates follow-up. [Copyright &y& Elsevier]