Background: In this study, we aimed to know the actual condition of cytology in Shiga from the results of external quality control obtained by local surveys and questionnaires for 10 years. Methods: The cytological quality control was performed using four images with clinical information. The answer was selected from five choices, and we requested that the cytological findings that led to the answer be described. Furthermore, we arranged the questions on “the propriety of the specimen” for two years, which recognized “quality assurance” as a recent concept of quality control. Using the questionnaire, we asked a number of cytotechnologists who belonged to each facility and their ages. Results: During the review, no facility had problems with basic cell judgments. However, on the cytological findings, there were no lists that they should have, or the lists did not appear in the images, which we showed. Therefore, we suggested improvements in the briefing session. On the propriety of the specimen, there were no facilities that had the wrong judgments; however, the grounds they examined were slightly fuzzy. Additionally, the investigations revealed that half of the cytotechnologists working in Shiga Prefecture were aged ≥ 50 years, and a remarkable aging situation was indicated. Conclusions: By law revision, the importance of external quality control is recognized, but in Shiga, the young group lacks interest. Conversely, it is a good tendency that the number of participants in the briefing session increased slightly owing to Web delivery that has recently become widespread. The cytotechnologists engaged in cytology had a problem, but they decreased the number of cytological examination duties to maintain balance with pathological examinations. On the basis of such situations, it will be more necessary to examine the questions’ contents, which will improve the actual situation.