Glandular cytology referrals to colposcopy clinics are relatively uncommon but their management often causes the most confusion.   Over the last ten years, there has been improved discrimination of the origin of gynaecological glandular cytology and this has made management pathways simpler. HPV triage of atypical glandular cytology has also improved colposcopy management pathways and reduced clinical uncertainty.  The rationale for current diagnostic, therapeutic and follow-up pathways in the English NHS screening programme embracing HPV and cytology testing will be explained.