BACKGROUND: Cervical cancer is the most common gynecologic cancer in women. Most of these cancers stem from infection with the human papillomavirus (HPV), although other host factors affect neoplastic progression following initial infection. Cervical cancer is one of the world’s deadliest but most easily preventable forms of cancer for women. Approximately 274,000 of the half a million women who develop cervical cancer annually will die from the disease, 85% of these deaths will occur in women in the developing world. Given the limited treatment options available for cervical cancer, public health experts recommend expanding prevention and screening programs to detect pre-cancerous changes in cervical tissue. In resource constrained facilities cervical cancer screening is mainly through Visual Inspection with Acetic Acid (VIA).Compared to HIV negative women, HIV-infected women are at a higher risk of HPV infection and persistence; they are also infected by a broader range of HPV types. In Tanzania, VIA is widely used as a cervical cancer screening tool, and management of the precancerous lesions are done based on these results. OBJECTIVES; To compare the proportion of precancerous cervical lesions among HIV positive women and HIV negative women attending RHC at KCMC from 20013-2015 METHODS; This study was a hospital based retrospective cross-sectional study aiming at establishing three years trend of the prevalence of precancerous cervical lesions of both HIV positive and negative women. The study was conducted to a population of women who attended RHC and got screened. Non probability convenient sampling method was used to collect all data that were recorded in the registry book between the years 2013 to 2015. Data processing and analysis will be done using SPSS version20. Ethical clearance was obtained from Tumaini University College Research committee and from Director of Hospital services KCMC. RESULTS; Out of 4333 women who got screened, 609(14%) were HIV-positive among these 109 were also positive for cervical precancerous lesions making a prevalence of 17.9% while 3162 were HIV-negative and among these 320 were positive for precancerous lesions of the cervix making a prevalence of 6.96%. The overall prevalence in all women who got screened was found to be 8.6%. CONCLUSION: A high prevalence of cervical precancerous lesions was found in HIV-positive women compared to HIV-negative women.