objective: establish the papanicolau (pap) smear prevalence amongst women 18 - 65 years old, affiliated to the susbsidiary regime and attended in the hospital la manga of barranquilla. methods: cross-sectional study that included 573 women from 18 - 65 years. the information was obtained by a survey. the statistical analyses were performed using epi-info 6.04. results: the average age was 39,46 years (sd+/-: 13.98). the papanicolau (pap) smear prevalence was of 34,2% (95% ci 30.35-38.27). the gynecological symptom increases the use of the pap to 47,2% (95% ci 33,51 - 61,23) compared with its absence in 32,9% (95% ci 28,89 - 37,13). the proximity of the institution promotes the use of pap in 35,2% (95% ci 30,80 - 39,88) compared with the women that take some kind of transportation 26,7% (95% ci 18,72 - 36,34). association was found association between the no-use of pap smear and to be between 60-65 years old (or=1.90 ic 95% 1.01-3.64), the no-knowledge about the pap smear utility (or=3.27 ic 95% 1.45-7.66), not have had childbirths (or=3.70 ic 95% 1.26-14.75), not use contraceptive methods (or=1.57 ic 95% 1.09-2.26) and absence of previous history of vaginal infection (or=1.65 ic 95% 1.10-2.47). conclusions: the pap smear prevalence was low for the studied population. it is necessary to extend the activities of health promotion and disease prevention to avoid the loss of opportunities at health programs.