Objective: Minimally invasive radical hysterectomy (RH) in early cervical cancer has been adopted as the standard approach. However, the recent clinical trial has revealed that women undergoing minimally invasive RH showed worse survival than those who received abdominal RH. This study evaluated oncologic outcomes of minimally invasive RH in FIGO stage IB-IIA cervical cancer patients after using parametrial invasion (PMI) prediction criterion and vaginal colpotomy. Methods: A total of 197 FIGO stage IB-IIA cervical cancer patients who underwent minimally invasive RH was identified between April 2006 and January 2018. Patients were classified into the pre-PMI IVC group (N=117) and post-PMI VC group (N=80). In the pre-PMI IVC group, PMI criterion on MRI was not applied and the patients received intracorporeal or vaginal colpotomy. In the post-PMI VC group, surgical candidates were selected using the disruption of cervical stromal ring on MRI and all patients received vaginal colpotomy only. Oncologic outcomes were compared between the two groups and prognostic factors associated with disease recurrence were analyzed. Results: The rate of positive vaginal cuff margins in the pre-PMI IVC group was significantly higher than that in the post-PMI VC group (10.8% vs. 1.2%, p = 0.008). Five-year disease-free survival was significantly different between the two groups (83.6% in pre-PMI IVC group vs. 97.5% in post-PMI VC group, p = 0.013). In multivariate analysis, disruption of the cervical stromal ring on MRI (OR, 12.909; 95% CI, 3.956-46.334; p ＜ 0.001) and intracorporeal colpotomy (OR, 2.596; 95% CI, 1.001-6.729; p = 0.050) were significantly associated with disease recurrence. Conclusions: Minimally invasive RH should be performed in optimal surgical candidates with intact cervical stromal ring on MRI to obtain en bloc resection without tumor exposure to the CO2 pneumoperitoneum, using vagina colpotomy.