OBJECTIVE: To assess the significance of nonatypical glandular cells in vaginal smears from patients who had undergone total hysterectomy. STUDY DESIGN: Vaginal smears with nonatypical glandular epithelium obtained from post-total hysterectomy patients were identified in our files over a 4.5-year period. The cytologic findings were correlated with the clinical data. RESULTS: Smears with nonatypical glandular epithelium from 15 post-total hysterectomy patients were identified, making this the largest series in the literature. The patients' mean age was 59 years. Most patients (73%) had a history of gynecologic malignancy, and 60% had received radiotherapy. All patients had a normal gynecologic examination when the vaginal smear was obtained. None of the patients developed recurrent or de novo vaginal adenocarcinoma. CONCLUSION: The presence of nonatypical glandular epithelial cells in smears from total hysterectomy patients is not indicative of adenocarcinoma.