Early invasive cervix carcinoma (up to FIGO stage IIa) may be treated with surgery. The aim of surgery is to preserve normal function and also to ensure complete removal of the tumour with adequate margins. New developments in the surgical management of cervix carcinoma include less radical surgery that may preserve fertility in young patients such as a cold-knife cone biopsy in very early lesions or more complex operations like radical trachelectomy, which entails removal of the cervix whilst maintaining the uterine body, in selected patients. The standard surgery for macroscopic, early cervical carcinoma is a radical hysterectomy with pelvic lymph node dissection. These patients should undergo surgery at a tertiary referral centre. Inappropriate surgical management may necessitate postoperative radiotherapy and thus increase the risk of associated complications.