Background: Colposcopy is an office gynecological procedure used for cervical evaluation in patients with abnormal cervical cytology. It is considered an important tool for early detection of cases of cervical cancer.Objective: To evaluate the evidence from published randomized clinical trials (RCTs) about the efficacy of local anesthetics in pain relief during colposcopic-guided biopsy.Data Sources: Several electronic databases included MEDLINE, EMBASE, Cochrane Library, ISI and Scopus were searched using the relevant MeSH terms.Methods Of Study Selection: All RCTs assessing the effect of local anesthetics in relieving pain during colposcopy were considered for this meta-analysis. There were 1339 studies identified of which 11 studies deemed eligible for this review. We performed quality and risk of bias assessment for all included studies.Data Extraction: Three researchers independently extracted the data from the individual articles and entered it into RevMan software. The extracted outcomes included pain scores and the duration of the procedure.Results: Eleven RCTs were included. Local anesthesia (LA) was associated with higher pain at speculum insertion than control (SMD = 0.23, 95% CI [0.03, 0.43]). While, LA significantly reduced biopsy pain than control (SMD= -0.57, 95% CI [-0.94, -0.20]). The overall pooled estimate showed no significant difference between LA and control regarding postprocedural pain, pain on endocervical curettage, pain expectancy, and overall pain scores.Conclusions: This meta-analysis suggests that local anesthetics are effective in pain relief during a colposcopic-guided biopsy; however there is no strong evidence to recommend its use in current practice. [ABSTRACT FROM AUTHOR]