The sensitivity of HPV testing for high-grade preneoplastic lesions and neoplasias of the cervix is extremely high. Therefore, it can be used, ideally in conjunction with thin-layer cytology, for the triage of borderline, questionable, and abnormal cytologic findings. In cases of Pap IIW, first Pap IIID, and Pap III without suspicion of glandular atypia, primary HPV testing is a reasonable approach. A patient with HPV-negative Pap IIW can return to normal screening intervals. In cases of HPV negativity together with Pap IIID and Pap III without suspicion of glandular atypia, this is possible after two normal cytologic findings. For recurrent Pap IIID, Pap III with suspicion of glandular atypia, and Pap IVa, a primary expert colposcopy with biopsy of the lesions is necessary. Without colposcopic evidence of lesions, conization (preferably LLETZ) is mandatory in cases of Pap III with suspicion of glandular atypia and Pap IVa (after revision of the cytologic and colposcopic findings). In cases of HPV-HR-positive Pap IIID without colposcopic evidence of lesions, under certain conditions follow-up at 3-month intervals is possible.