To characterize the hrHPV genotype distribution and attribution to cervical lesions in the cohort of women screened in Shanxi Province. Data from the records of cervical cancer screening programs for rural women in Shanxi Province were retrospectively collected. Women who underwent primary human papillomavirus (HPV) screening between January 2014 and December 2019 were included. The attribution proportion of specific hrHPV types for different grades of cervical lesions was calculated by using the type contribution weighting and the proportional attribution methods to estimate the potential impact of HPV vaccines on CIN II + lesions. CIN II + lesions were observed mainly with HPV16 (65.85%), HPV18 (10.20%), HPV58 (10.20%), HPV52 (7.98%), HPV31 (4.66%), HPV33 (4.43%), HPV51 (2.22%) and HPV56 (2.22%). A total of 97.42% of all CIN II + lesions were attributed to HPV16, HPV18, HPV52, HPV58, HPV31, HPV33 and HPV35. A total of 75.4% (95% CI, 71.4-79.3) of CIN II + lesions were attributable to HPV16/18, and 21.1% (95% CI, 17.4-25.1) were attributable to the 5 additional types (HPV31/33/45/52/58) covered by the 9-valent vaccine. The prevalence of hrHPV infection among women in Shanxi Province was high, and HPV16, HPV18, HPV58, HPV52, HPV31, HPV33 and HPV35 had the highest attributable proportion of CIN II + lesions. The type-specific HPV prevalence and attribution proportion of cervical precancerous lesions should be taken into consideration in both clinical management and the design of preventive strategies.