OBJECTIVES: The goal of this research was to determine whether the presence of inflammation or an increased number of granulocytes makes it difficult to detect HSIL lesions. STUDY DESIGN: A retrospective cross-sectional comparative study. PARTICIPANTS AND METHODS: The study included subjects on whom was performed a cytological review of VCE smear at the Department of Clinical Cytology, Clinical Hospital Center Osijek in the period from 2007 to the end of 2016, provided that in the time interval of 6 months after the cytological diagnosis they had pathohistologically verified HSIL lesion. Histological findings were made at the Department of Pathology and Judicial Medicine, Clinical Hospital Center Osijek. RESULTS: The study was conducted on 1296 respondents. Inflammation was found in 370 (28.5%) respondents. Increased number of granulocytes was found in the smears of 170 (13.1%) subjects, significantly more frequently in the examinees with cytological diagnosis ASCH, CIN 1, ASC, AGC and in subjects with negative findings. B. vaginalis, G. vaginalis, HPV and T. vaginalis were more commonly found in the smear with signs of inflammation. Cytological diagnosis CIN 2 was confirmed patohistologically in 39.3% cases and CIN 3 in 67% cases. There are no statistically significant differences in the cytological diagnosis of HSIL lesions with regard to the presence of inflammation and granulocytes. CONCLUSION: Despite the fact that the inflammation and granulocytes can act as obscuring factors, there is no statistically significant difference in the cytodiagnosis of HSIL lesions in smears with or without inflammation and with or without an increased number of granulocytes.