Cervical cancer screening employed cervical cytology for the past 50 years. Now is the era of a paradigm shift in cervical cancer screening. The screening process and guidelines are undergoing significant changes as our understanding of the HPV virus, and its role in carcinogenesis become greater, as well as the effects of HPV vaccination. The future of cervical cancer screening is being driven towards primary HPV testing and HPV genotyping, especially in the post-HPV vaccination era.