OBJECTIVE:To test the hypothesis that lubrication of the vaginal introitus and external speculum does not adversely affect Papanicolaou interpretation. METHOD: One hundred eighty-two patients presenting for Papanicolaou smears as part of their visit were randomly assigned to have either only warm water or a water soluble lubricant to assist speculum insertion. Cytotechnicians and pathologists were blind to the cohort from which smears were obtained. RESULTS: Two unsatisfactory smears were found among 93 patients with the lubricant and two were found among 89 using only warm water. No significant difference was found using the t test for continuous variables and chi(2) for categoric variables. CONCLUSION: Use of a water soluble lubricant on the vaginal introitus and external speculum facilitates examination with no adverse effect on Papanicolaou smear interpretation.