Women with inflammatory bowel disease IBD may be at higher risk for cervical intraepithelial neoplasia CIN. However, data are conflicting. The aim of this study was to assess the risk of high-grade dysplasia and cancer CIN2+ in IBD women and identify risk factors. Clinical data from adult IBD women in a multicentre Dutch IBD prospective cohort PSI from 2007 onwards were linked to cervical cytology and histology records from the Dutch nationwide cytology and pathology database PALGA, from 2000 to 2016. Patients were frequency-matched 1:4 to a general population cohort. Standardised detection rates SDR were calculated for CIN2+. Longitudinal data were assessed to calculate CIN2+ risk during follow-up using incidence rate ratios IRR and risk factors were identified in multivariable analysis. Cervical records were available from 2098 IBD women 77% and 8379 in the matched cohort; median follow-up was 13 years. CIN2+ detection rate was higher in the IBD cohort than in the matched cohort (SDR 1.27, 95% confidence interval CI 1.05-1.52). Women with IBD had an increased risk of CIN2+ IRR 1.66, 95% CI 1.21-2.25 and persistent or recurrent CIN during follow-up (odds ratio OR 1.89, 95% CI 1.06-3.38). Risk factors for CIN2+ in IBD women were smoking and disease location (ileocolonic L3 or upper gastrointestinal GI L4). CIN2+ risk was not associated with exposure to immunosuppressants. Women with IBD are at increased risk for CIN2+ lesions. These results underline the importance of human papillomavirus HPV vaccination and adherence to cervical cancer screening guidelines in IBD women, regardless of exposure to immunosuppressants.