From January 1962 until July 1978, 44 patients with invasive cervical cancer at exploratory surgery were found to have positive lymph nodes. Forty-three of these patients received radiation as definitive therapy after the discovery of lymph node metastasis. One patient had a positive left scalene biopsy as well and was treated only with chemotherapy. Thirty-three of the patients were clinically Stage IB. Two patients were Stage IIA, while 7 were IIB. There was 1 individual staged as IIIB. One patient was unstageable because of carcinoma found at operation for benign disease. Histologically, 35 of the 44 had squamous cell carcinoma. Five patients had adenocarcinoma, while 2 were adenosquamous. One patient was noted to be glassy cell type, and 1 patient had small cell undifferentiated carcinoma. Evaluation of the 44 operative specimens comparing clinical stage to highest positive node revealed that 32 patients (73%) had external iliac/obturator node involvement. Twenty-five of these were clinically Stage I disease. Twelve patients (27%) had involvement above the external iliac/obturator level and 8 of these were clinically Stage I. It is evident that a number of patients who are thought to have early disease clinically may have more advanced disease surgically and pathologically. Using the actuarial method of Berkson and Gage, the 5-year survival rate of the entire 44 operated patients was 52%. For comparison with other studies, we have additionally divided the patients into: (1) 22 who had completed hysterectomies and lymph node dissections followed by radiotherapy; (2) 22 who had lymph node sampling followed by radiation or chemotherapy alone. The actuarial survival of the first group was 71%. The survival of the second group, which included clinical Stages I, II, and III and one unstageable patient, was 34%.