The purpose of this study is to investigate the prognostic role of pre-treatment squamous cell carcinoma-related antigen (SCC-Ag) level in patients with squamous cell carcinoma of the uterine cervix. Methods In this study, we retrospectively enrolled patients with squamous cell carcinoma of the uterine cervix (FIGO stage IB to IVA) who were treated at Samsung Medical Center, Seoul, Korea, from 1996 to 2007. Results We retrospectively enrolled 788 patients. Median SCC-Ag level was 1.6 ng/mL (reference range, 0.1-362.0) in all patients. Four hundred seven out of 788 patients had elevating pre-treatment SCC-Ag level (51.6%). When we divided the cohort based on the stage (early cervical carcinoma; IB1 and IIA vs. locally advanced cervical carcinoma [LACC]; IB2 and IIB to IVA) and performed multivariate analysis, pre-treatment SCC-Ag entailed prognostic significance only in LACC (progression-free survival: hazard ratio [HR], 1.007; 95% confidential interval [CI], 1.003-1.010; overall survival: HR, 1.005; 95% CI, 1.001-1.009). Among patients who showed recurrence disease and had the result of SCC-Ag before recurrence (n=94), 79 patients (84.0%) had the elevation of SCC-Ag level at the time of recurrence. Conclusion Pre-treatment SCC-Ag level is an independent prognostic factor for survival in patients with LACC. Measuring pre-treatment serum SCC-Ag may be a cost-effective method to predict prognosis in patients with LACC.