Background: Cervical cancer is a major cause of death among women, with 528,000 new cases annually. It is the fourth most common cancer affecting women worldwide, with nearly 70% of the global burden falling in areas with lower levels of development. This study aimed to evaluate the performance of colposcopy in estimating the presence of cervical lesion as a secondary test modality to triage women found positive on visual inspection with acetic acid (VIA) test. Methods: This prospective cross-sectional study was conducted on 100 women at Obstetrics and Gynecology clinics of Benha University Hospitals from May 2023 till November 2023. Results: The mean blood pressure was 123.87 with a standard deviation of 9.5, 73.03 with a standard deviation of 8.42, and 15.26 with a standard deviation of 3.79. The mean hemoglobin was 11.13 with a standard deviation of 1.03, and the mean red blood cell count was 4.76 with a standard deviation of 0.28, and 7.77 with a standard deviation of 1.65. The majority of patients had squamous metaplasia, leukoplakia, condyloma/wart, cervical intraepithelial neoplasia CIN1 (70%), CIN2–3 (7%), and invasive carcinoma (3%). Conclusion: VIA and colposcopy are crucial diagnostic tools for cervical pre-malignancy, particularly in underdeveloped countries. VIA is often used alongside colposcopy for screening, while colposcopy is a sensitive test for detecting cervical cancer and can be used as a secondary test to triage women positive on VIA.