Villoglandular papillary adenocarcinoma (VGA) is a rare subtype of cervical adenocarcinoma. It tends to appear in younger women and its indolent behavior permits fertility-preserving treatments. Pathologically, VGA presents a diagnostic challenge. The aim of our study was to evaluate the reliability of histological assessment for pre-treatment diagnosis of VGA. The data from the outpatient files of 12 patients in whom VGA had been diagnosed were reviewed. Median age at diagnosis was 38.8 years (range 27-65). Final pathology results confirmed VGA in nine patients. Of these, only two had been correctly diagnosed preoperatively, while in three, the initial biopsies were benign or pre-malignant. In four patients, the biopsy results had been interpreted as an invasive malignant tumor necessitating hysterectomy. The final histological report on the remaining three patients was invasive cervical adenocarcinoma. We conclude that pre-treatment diagnosis should not be based solely on a simple punch biopsy because of its low rate of diagnostic accuracy.