Objective To investigate the predictive value of HPV combined with TCT (thinprep cytology test) in the diagnosis of cervical lesions. Methods 90 patients with cervical lesions from February 2019 to February 2020 were selected as the research objects. HPV detection, TCT detection and colposcopy biopsy were carried out for all patients. The colposcopy results were taken as the gold standard. The comparison of TCT detection and pathological results, HPV detection and pathological results, joint detection and pathological results comparison and diagnostic accuracy were statistically analyzed. Results Pathological examination showed that 27 cases of normal cervix, 27 cases of CIN Ⅰ, 11 cases of CIN Ⅱ, 14 cases of CIN Ⅲ and 11 cases of cervical cancer; TCT showed 19 cases of normal cervix, 33 cases of ASCUS, 22 cases of LSIL, 12 cases of HSIL and 4 cases of SCC. HPV test showed that 73 cases were positive and 17 cases were negative; 88 cases were positive and 2 cases were negative by combined detection; there was no significant difference between the accuracy of combined detection and pathological results, P>0.05. Conclusion HPV detection combined with TCT detection in cervical lesions has high predictive value, high accuracy and non-invasive. It can effectively reduce the probability of colposcopy biopsy or surgical exploration. It makes patients with relatively light medical burden, may be applied to large-scale screening of cervical lesions.