We reviewed the clinical and pathological features of 24 cases of well-differentiated villoglandular adenocarcinoma of the uterine cervix. The patients' ages ranged from 27 to 54 years, with an average age of 37. At least 15 patients were taking oral contraceptive prior to diagnosis, compared to five of 18 in a control group of patients with various other histologic types of cervical adenocarcinoma. All of the neoplasms were exophytic polypoid lesions with thick or thin papillae lined by endocervical, endometrial or intestinal-type epithelium showing mild cytologic atypia. Ten were associated with adenocarcinoma in situ, eight with cervical intraepithelial neoplasia, and one with microglandular hyperplasia. All tumors were confined to the cervix. Five patients were treated by excisional biopsy or cone biopsy, four by simple hysterectomy with prior or subsequent radiation therapy, and 15 by radical hysterectomy. All patients are alive and well, with no evidence of recurrent disease. The follow-up ranged from 7 to 77 months, with a mean of 36 months.