There are a lack of reports about the adverse effects of Lugol iodine solution staining of the genital epithelia, known as a Schiller test, during colposcopy. We report that during the Schiller test, a patient complained of an anaphylactic-like reaction to the Lugol solution with vaginal and generalized pruritus, vaginal edema, hypotension, tachycardia, and breathing difficulties. Vaginal iodine was completely washed out with saline solution, resulting in improvement and a disappearance of the symptoms without the use of any drugs. The safety of Lugol staining during colposcopy needs to be assessed. © 2009 by The Southern Medical Association.