Cervical cancer is a significant cause of morbidity and mortality among women in developing countries. This study set out to determine the knowledge of cervical cancer, utilization of cervical cancer screening services and predictors of precancerous cervical changes among sexually active women in Lagos, Nigeria. The study was cross sectional in design. A multistage sampling technique was used to select 332 women.Questionnaire was used to collect data. In addition, Visual Inspection with Acetic Acid (VIA) and Visual Inspection with Lugol''s Iodine (VILI) of the cervix. Data were summarized and tests for association were done. The mean age of respondents'' mean age was 39.0 years +_ 10. Only (135) 41.9% of respondents were aware of cervical cancer. Eleven respondents (3.3%) had ever had a cervical cancer screening done. On logistic regression,multiple sexual partnering and early coitache predicted having precancerous cervical changes. There was poor knowledge and low utilization of cervical cancer screening services.