Objective：This study aims to analyze the high risk factors of residual lesions in patients with positive cervical margin after loop electrosurgical excision procedure（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 negative conversion ratio of 112 patients with positive surgical margin was 75.9% during 6 months follow-up. Postmenopausal patients and multiple quadrants of margin involvement were inversely associated with positive ectocervical margin after conization. While the preoperative thin-prep cytology test（TCT） results，pregnancy and birth order，the degree of surgical margin lesions showed no correlation with the outcome of the patients. Among the 193 patients with positive non-ectocervical margin，menopausal status，preoperative TCT results including atypical squamous cell cannot exclude high grade squamous intraepithelial lesion（ASC-H） and high-grade squamous intraepithelial lesion（HSIL），and positive margin involved multiple quadrants，all of them were positively correlated with residual lesions. While the patient’s age，gestational order，preoperative human papilloma virus（HPV） type and preoperative lesion degree showed no correlation with lesion residual. Conclusion：Routine follow-up is feasible for patients with positive ectocervical margin for the high negative conversion ratio. The probability of postoperative residual lesions in patients with positive non-ectocervical margin is high in patients with menopause， the preoperative TCT show ASC-H or HSIL，and peripheral margin involved multiple quadrants，so hysterectomy is recommended.