Objective: To evaluate the effectiveness of repeat loop electrosurgical excision procedure (LEEP) conization ill patients with cervical intraepithelial neoplasia (CIN) grade 3 and positive ectocervical margins. Method: A retrospective study of 56 women who Underwent repeat LEEP conization for CIN 3 and positive ectocervical margins. Results: Final diagnosis after repeat LEEP conization revealed 6 women (10.7%) with microinvasive squamous cell carcinoma (Stage IA1): 1 (1.8%) with CIN 1; 1 (1.8%) with CIN 2; 21 (37.5%) with CIN 3: and 27 (48.2%) with chronic cervicitis. Ectocervical or endocervical margins were negative after repeat LEEP conization in the majority of women, except lot 2 patients (3.6%) with CIN 3 and positive ectocervical margins. Recurrence rate for file median follow-up time of 2 years was 6.1% (3 patients). Conclusion: Repeat LEEP conization car) reveal undiagnosed microinvasive cervical carcinoma in women with positive ectocervical margins. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.