Abstract: Objective To explore predictive factors for post-cone residual disease in subsequent hysterectomy for cervical intraepithelial neoplasia(CIN)Ⅲ. Methods We determined the relationship between residual disease and clinical features, cone marginal status, CIN grade of positive cone margin, conization type by retrospectively reviewing 90 CINⅢpatients who received hysterectomy following cervix conization. Results All cases were followed up for 42-66 months and no recurrence was found. Residual disease was detected in 55 hysterectomy specimen (55/90, 61.11%). There was no significant difference of residual disease incidence between age >40 (33/47, 70.2%) and age ≤40(22/43, 51.2%), HPV-H positive(32/52, 61.5%) and negative(1/2, 50.0%), and LEEP(49/78, 62.8%) and CKC group (6/12, 50.0%) (P>0.05). The residual disease incidence in patients with positive cone margin (38/53, 71.7%)was higher than that with negative cone margin (17/37, 46.0%,P<0.01). The residual disease incidence in patients with cone margin of CINⅡ-Ⅲ(27/33, 81.8%) was higher than that of CINⅠ (11/20, 55.0%,P<0.05). Conclusion Positive cone margin, especially with high CIN grade, is the predictive factor for residual disease in subsequent hysterectomy following conization for CINⅢ and the patients should be attended to further treatment and closely following up. The clinicians could control the cone marginal status to reduce residual disease.