Persistence of high-risk Human papillomaviruses (HR-HPV) infection increases the risk of precancerous lesions development. The aim of this study was to assess the persistence and clearance rate of HPV infection. A prospective cohort study was conducted between January and December 2023 among patients attending gynecology unit of FHCSH in Bahir Dar, northwest Ethiopia. Out of 297 study participants, 95 women with HPV infected and cytological abnormalities were followed
of these 93.7% were HPV positive at the baseline study. Of which, 46.1% did not receive treatment, the rest 53.9% were treated. Among the women without treatment, HPV persistence and clearance rates were 65.9% and 34.1% respectively while persistence rate of 46.3% and clearance rate of 53.7% were observed in 12-month follow up period. Among women who received treatment, HPV persistence rate of 45.8% and clearance rate of 54.2% were recorded in six while persistence rate of 33.3% and clearance rate of 66.7% were observed in 12- month follow up period. The findings of our study indicated that the high persistence rate and low clearance rate of HPV infection. Detection of persistent HPV infection without treatment or after treatment should be considered as the main risk factor for the development or recurrence of cervical neoplasia.