The cervix is a vulnerable site for lesions including injury, inflammation, tumors, and endometriosis. The main cervical lesions usually associated with hysterectomy are cervical intraepithelial neoplasia and cervical cancer. Most cervical intraepithelial neoplasia develops slowly and somewhat progressively and can subside and be reversed. The progression from cervical intraepithelial neoplasia grade I → grade II → grade III → cervical invasive carcinoma usually takes several years to more than 10 years. The higher the grade of cervical intraepithelial neoplasia, the lower the chance of its regression and reversal, and the higher the chance of its development into invasive carcinoma. Is it necessary to remove the uterus for cervical cancer? Usually, only invasive cervical cancer requires hysterectomy, but for young infertile patients with early squamous cancer who are eligible, a procedure that preserves fertility, i.e. extensive hysterectomy, is also possible. Only a small percentage of patients with cervical intraepithelial neoplasia require hysterectomy, and hysterectomy is mainly considered for those who are old, menopausal, with grade III lesions or carcinoma in situ, with extremely extensive lesions as indicated by pathological examination after cervical conization, without fertility requirements and with excessive psychological pressure for recurrence of lesions. The majority of patients with cervical intraepithelial neoplasia can be cured by local surgery. Local cervical surgery includes cervical loop electrosurgery (i.e. LEEP), cervical cold knife conization and extensive hysterectomy. 1. Cervical loop electrosurgery is a local conical excision of cervical tissue using a special high-frequency electric knife. This procedure is usually done for both therapeutic and diagnostic purposes. The advantage of LEEP surgery is that it is simple, fast and less bleeding, but due to the electrothermal damage that may affect the pathological judgment of the cut edge, most of the cervical precancerous lesions are performed by this surgery. Most cervical precancerous lesions are now treated by this method. 2.Cervical conical excision, also known as cervical cold knife conization, has the same purpose as LEEP surgery, both are for further diagnosis and treatment, the difference is that the surgery is performed with an ordinary scalpel (i.e. cold knife) instead of an electric knife, so there are disadvantages such as more bleeding during the operation, need for suturing and long operation time, etc. The advantage is that the tissue specimens obtained after the operation are fresh, especially the cut edge of the operation is not affected by electrothermal damage, which facilitates the pathological examination. The advantage is that the tissue specimen obtained after surgery is fresh, especially the surgical margin is not affected by electrothermal damage, which facilitates the accuracy of pathological examination. 3.Extensive hysterectomy is suitable for young patients with strong fertility requirements for early-stage squamous cervical cancer, specifically, the following conditions must be met: the patient is a young woman who is extremely eager to have children; there are no other infertility factors; the tumor lesion is ≤2 cm; the cancer FIGO stage (2009) is Ia-Ib; the tumor has no obvious parametrial infiltration; the tumor is confined to the external cervical opening, and hysteroscopy does not reveal any tumor above the endocervical opening. no cancerous infiltration above the endocervix on examination; no metastasis or enlargement of regional lymph nodes on physical examination or imaging; more caution would be exercised in case of cervical adenocarcinoma and this procedure is generally not recommended. The advantage of this procedure is that it preserves the patient’s reproductive function, but there is a risk of postoperative recurrence and progression of the cancer, and it requires full assessment of the condition, clinical stage, type of pathology, and full communication with the patient and informed consent before this procedure can be performed.