Purpose of investigation: The authors evaluated the safety and effectiveness of topical imiquimod for the treatment of high-grade cervical intraepithelial neoplasia (HG-CIN), to avoid excisional therapy in young women who desired fertility-sparing. Materials and Methods: Fifty-four patients with high-grade CIN (2, 3) who refused excisional therapy were included. Imiquimod was applied to the patient’s cervix by a gynecologic oncologist. Results: The median age was 30 (range, 22-42) years and the median follow-up period was 13.4 (range, 2.6-32.1) months. Twenty-three (42.6%) patients had CIN 2 and 31 (57.4%) had CIN 3. Fifty-two (96.3%) patients were positive for human papillomavirus (HPV). All patient completed at least the eight times of imiquimod therapy without serious adverse effects. After the treatment, the regression rate was 83.3%, and HPV eradication rate was 33.3%. Conclusion: Topical imiquimod therapy could be an alternative treatment of HG-CIN in young women who want of pregnancy.