Objective: This study aimed to estimate the incidence of PI in patients with early-stage CC and establish a simple nomogram to identify a cohort of patients with low risk of PI who may benefit from less radical surgery. Methods: All patients who underwent radical hysterectomy and pelvic lymphadenectomy were included from 2013 to 2018. The significant independent predictors were identified through Cox regression analysis and then incorporated into a nomogram to predicate PI. The calibration plots and receiver operating characteristic (ROC) curves for assessing the predictive accuracy of the nomogram. Findings: Of 4533 patients met the inclusion criteria, 441 women (9.7%) had PI. The positive PI rate in the less than equal to 2 cm group (1.2%) was significantly lower than in greater than 2-less than equal to 4 cm (6.2%) or greater than 4 cm (22.4%) groups. Multivariate analyses revealed that tumor size (P=0.002), lymph vascular space invasion (LVSI) (P=0.001), vaginal involvement (VI) (P<0.001), statue of pelvic lymph nodes (PLN) (P=0.001), and depth of stromal invasive (DSI) (P<0.001), were independent prognostic factors of PI. Finally, five variables were combined to construct nomogram model. The concordance indexes (C-indexes) of PI were 0.756 (95% CI, 0.726-0.786) for the internal validation and 0.729 (95% CI, 0.678-0.780) for the external validation. Calibration plots further showed good consistency between the nomogram prediction and actual observation. Interpretation: This nomogram based on significant clinicopathological characteristics provided a reliable tool for clinicians to predict PI among early-stage CC patients, who might benefit a less radical surgery. Funding: Funding: The Clinical Research Plan of SHDC (SHDC2020CR1045B) to Keqin Hua; Shanghai Municipal Health commission (20194Y0085) to Chunbo Li; The Shanghai “Rising Stars of Medical Talent” Youth Development Program (SHWSRS2020087) to Chunbo Li. Declaration of Interest: Ethical Approval: This study was approved from the Medical Ethics Committee of our hospital.