Endocervical curettage (ECC) is a simple way of exploring the endocervical canal and is useful for the management of a patient with an abnormal smear. If colposcopy is satisfactory, ECC is usually negative confirming that the canal is free of disease and out-patient treatment can be used. A positive ECC warrants conization. If colposcopy is not satisfactory, ECC is usually positive, confirming extension of the disease in the canal, and sometimes the presence of an invasive lesion requiring a radical treatment right away. An endocervical adenocarcinoma alone or associated with an epidermoid lesion may also be identified. Post cone ECC confirms the absence of residual disease. Follow-up of patients after treatment and/or the menopause with an ECC is helped, especially when the squamocolumnar junction is not seen.