Locally advanced carcinoma of the uterine cervix is a major public health problem in developing countries. In spite of advancement in chemoradiation therapy, the outcome of locally advanced disease remains suboptimal. Newer diagnostic methods, treatment approaches and technology to evaluate the response needs to be evaluated in this condition. Some of the current issues of management of cervix cancer in developing countries are discussed in this present review. The direction of future research in imaging and neoadjuvant therapy are highlighted.