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Yanyan Li,1 Zhanzhan Li,2 Guangying Zhang2,3 1Department of Nursing, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, People’s Republic of China; 2Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, People’s Republic of China; 3National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, People’s Republic of ChinaCorrespondence: Guangying Zhang, Department of Oncology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Kaifu District, Changsha, Hunan Province, 410008, People’s Republic of China, Email 22019046@csu.edu.cnBackground: The width of red blood cell distribution (RDW) is correlated with some diseases, but its clinical value and prognostic role in cervical cancer is unclear.Methods: We used receiver operating characteristic curves to evaluate the diagnostic ability of RDW and other clinical parameters in cervical cancer based on a case–control design. Using retrospective data, we explored the correlation of RDW with overall (OS) and progression-free (PFS) survival using Kaplan–Meier analysis and univariate and multivariate Cox regression with the hazard ratio (HR) and 95% confidence interval (CI). A restricted cubic plot was used to evaluate the nonlinear association between RDW and prognosis risk.Results: RDW was significantly higher in cases than in controls (14.6± 1.7 vs 12.5± 1.8, P< 0.001). It showed high diagnostic accuracy for cervical cancer, with a sensitivity of 79.3%, specificity of 65.6%, and area under the curve of 0.802 (95% CI, 0.775– 0.827) with a cutoff value of 13.88. There was a significant positive correlation between RDW and C-reactive protein (r=0.434, P=0.023). Multivariate Cox regression indicated that it was independently associated with a poorer PFS (HR, 2.05; 95% CI, 1.25– 3.18, P< 0.001) and OS (HR, 2.73; 95% CI, 1.61– 4.64, P< 0.001). RDW> 14.66 showed a nonlinear increased risk for a poor PFS and OS.Conclusion: RDW is an easy, quick, and inexpensive tool for the early detection and risk management of cervical cancer. A greater RDW is associated with a poor prognosis in cervical cancer.Keywords: cervical carcinoma, red blood cell distribution width, diagnostic, prognosis