BACKGROUND Small cell neuroendocrine cervical carcinoma (SCNCC) is a rare tumor that comprises 1-3% of cervical tumors. SCNCC exhibits clinical and biological characteristics of both cervical neoplasm (such as local aggressiveness and involvement of papillomavirus) and neuroendocrine small cell cancer of any site (such as early dissemination of the disease and loss of heterozygozity at different loci) making it an original nosologic entity. There is no unanimous opinion regarding the optimal management strategy. CASE REPORT A 48-year-old Caucasian woman, para 3, referred postmenopausal bleeding of 2 months' duration. Preoperative investigation diagnosed an infiltrating squamous carcinoma of the cervix. A radical hysterectomy with bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy were performed. Final diagnosis was SCNCC (FIGO stage III B) and therefore adjuvant radiochemotherapy was given. At 1-year follow-up the patient was free of disease. CONCLUSION Despite the retrospective studies and case reports reported, in literature the best modality of treatment remains controversial. Multicenter clinical trials are needed to determine a univocal and effective treatment for SCNCC in order to achieve significant survival benefit.