The state anxiety scores of women with abnormal cervical smears referred for colposcopy were investigated to identify causes of anxiety, factors influencing anxiety and emotions involved with anxiety, in order to define strategies to reduce this anxiety. Forty-seven women were interviewed and completed a questionnaire and the Spielberger State and Trait Anxiety Inventory (STAI): 22 women prior to their intake consultation at the colposcopy clinic of the University Medical Center St Radboud, Nijmegen, and 25 women during their second visit before the actual colposcopy. The mean State anxiety score was 48.2, without significant differences between the intake and colposcopy consultation. The majority experienced anxiety because of a fear of cancer and/or the colposcopy. The mean State anxiety score was significantly higher in women who considered the level of information provided by the gynecologist/family practitioner insufficient, who experienced a long waiting time, who did not have a partner, and who experienced additional emotions like anger and sadness. In conclusion, patients referred for colposcopy after an abnormal cervical smear result have high levels of anxiety. High levels of anxiety may be reduced by uniform and explicit information about cervical smear results and colposcopy, by reduction of clinic waiting times, by stimulating social support, and by attention to emotions like anger and sadness.