Cervical cancer is an important woman’s health problems worldwide, especially in low socio-economiccountries. The aim of this study was to compare the Pap smear screening results between Akha hill tribe andurban women who live in Chiang Rai province, Thailand. Screening was conducted for 1,100 Akha women and1,100 urban women who came to have the Pap smear at Chiangrai Prachanukroh Hospital and 1 private cytologylaboratory from January to June 2008. The demographic characteristics and factors related to abnormal Papaccording to the Bethesda 2001 system. The results showed that the prevalence of abnormal Pap smears was12.2% in Akha women and 4.5% in urban women. The highest prevalence of Pap abnormalities was found inthe 41-50 years age group in both populations (4.5% in Akha and 1.7% in urban women). In both populations,abnormal Pap smears were found in <21 years age groups. From the questionnaires, the possible risk factors related to the higher prevalence of abnormal pap amears in Akha woman wrew early age at marriage(17 years), high frequency pregnacies and high parity and no/low education level. In conclusion, cervical cancer control by education and early detection by Pap smear screening is necessary for hill tribe women. More Pap smear screening service units should be set to improve the coverage for the risk group women who got married in young age, especial in ethnic groups.