Objective: The study amis to analyze the high risk factors of residual lesions in patients with positive cervical margin after LEEP for high-grade intraepithelial cervical lesions, and to explore the stratified management of patients with different positive margins. Methods: A total of 305 patients with LEEP were collected. The postoperative specimens were pathologically confirmed to have residual cervical intraepithelial lesions at the margin of resection, namely, positive margin of conization. Routine postoperative follow-up was performed for patients with positive ectocervical margin to investigate the postoperative outcome. At the same time, all patients with positive non-ectocervical margins (endocervical margin and basal margin) were treated with a second LEEP or hysterectomy, and the high-risk factors for postoperative residual lesions in patients with positive non-ectocervical margins were analyzed. Results: The outcome rate of 112 patients with positive surgical margin was 75.9% during 6 months follow-up. Age > 50 years old, postmenopausal, preoperative HPV type 16 infected patients and multiple quadrants of margin involvement were inversely associated with positive ectocervical margin after conization. There was no correlation between the preoperative TCT results, pregnancy and birth order, and the degree of surgical margin lesions and the outcome of the patients. Among the 193 patients with positive non-ectocervical margin, Menopausal status, preoperative TCT results which were inculded ASC-H or HSIL patients and positive margin involved multiple quadrants, all of them were positively correlated with residual lesions. There was no correlation between the patient's age, gestational order, preoperative HPV type and preoperative lesion degree and lesion residual; Conclusion: Routine follow-up is feasible for patients with positive ectocervical margin. The patients with positive non-ectocervical margin were in menopause, and the preoperative TCT results were ASC-H or HSIL, at the same time,the probability of postoperative residual lesions with multiple quadrants of peripheral margin involvement was high, so hysterectomy was recommended.