Objective To explore the preliminary evaluation of HPV E6/E7 mRNA combined with cytology for early screening of cervical cancer. Methods A total of 825 patients who underwent cervical cancer screening in our hospital from October 2015 to July 2019 were collected. HPV E6/E7 mRNA and TCT were detected, and the diagnostic efficacy was analyzed using histopathology as the standard to evaluate the risk of cervical lesions in patients. Results The positive rates of cervical chronic inflammation, low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and cervical cancer detected by HPV E6/E7 mRNA and TCT were 12.17%, 39.04%, 86.61%, 87.88% and 36.51%, 82.89%, 82.14% and 81.82%, respectively. The sensitivity, specificity and accuracy of HPV E6/E7 mRNA detection were 86.90%, 80.44% and 81.58% respectively. The sensitivity, specificity and accuracy of TCT were 82.07%, 50.74% and 56.24% respectively. The sensitivity, specificity and accuracy of HPV E6/E7 mRNA combined with TCT were 70.34%, 83.68% and 81.33%, respectively. The specificity of HPV E6/E7mRNA combined with TCT was higher than that of single detection, and the difference was statistically significant (P＜0.001) The area under ROC curve of HPV E6/E7 mRNA and TCT were 0.837 and 0.664, respectively, and the area under ROC curve of the combined detection of HPV E6/E7 mRNA and TCT was 0.860, and the difference was statistically significant (P＜0.001), which suggesting that the combined diagnosis can improve the performance of the diagnosis of cervical HSIL+ Conclusion HPV E6/E7 mRNA combined with TCT can better predict the progression of cervical lesions, and has higher specificity for high-grade cervical lesions，and can provide reference for clinical cervical cancer screening