Stage IB carcinoma of the cervix may be treated primarily by either radiotherapy of operation. A primary surgical approach was used in 95 patients for the following indications: young age with desire to retain ovarian function (124), pelvic inflammatory disease (33), pregnant or post partum (15), refusal of radiotherapy (11), anatomic problems contraindicating radiotherapy (10), undiagnosed pelvic mass (seven), verrucous tumor (three), mucus-secreting tumor (two), syphilis (one), and previous radiotherapy for Hodgkin's disease (one). Twelve patients had two indications. The surgical procedures were radical abdominal hysterectomy and pelvic lymph node dissection (191) and Schauta-Amreich (radical vaginal) hysterectomy (4). Fourteen patients had serious postoperative complications. The uncorrected 5-year survival rate (95.1% follow-up) was 91.1%. The rationale for recommending a primary surgical approach to selected patients with Stage IB cervical carcinoma is presented.