Introduction. Although the FIGO staging system has been recently described for microinvasive adenocarcinoma of the cervix, the precise role it will have on determining how patients are treated remains uncertain. Using various definitions for the classification of microinvasion, recent reports have suggested conservative management for patients with this disease. Case. We present the case of a 62-year-old woman with FIGO stage IA1 adenocarcinoma of the cervix found to have bilateral microscopic pelvic lymph node metastases. To our knowledge, this is the only documented case of lymph node metastases in a patient with IA1 disease. Conclusions. A review of the controversial issues involving the definition and management of microinvasive adenocarcinoma of the cervix is presented. The finding of lymph node metastases in our patient provides support for aggressive surgical management in selected patients with this disease. (C) 2000 Academic Press.