Despite new therapies for cervical cancer, innovative strategies are essential to overcome drug resistance and high toxicity. The present study focuses on the metabolic profiling of cervical carcinoma using a non-targeted metabolomics approach using liquid chromatography-mass spectrometry. Our study identified over 70 metabolites in cervical tissue samples (both cancerous and adjacent normal) using HILIC and reversed-phase chromatography in the positive and negative ionization modes. Major metabolic alterations included changes in nicotinamide metabolism, ammonia recycling, amino acid metabolism and nucleotide metabolism, in a grade-dependent manner. Compared to normal tissue, HPV-positive tumors showed elevated nicotinamide metabolism, and phosphatidylethanolamine biosynthesis, whereas HPV-negative tumors showed enriched purine and pyrimidine metabolism. We validated our findings by analyzing transcriptomics datasets from the Gene Expression Omnibus database to understand the expression patterns of the underlying genes involved in the dysregulated pathways. We observed that nicotinamide metabolism exhibits significant effects in lower-grade cervical cancers and specific HPV genotypes. We treated cervical cancer cell lines with niacinamide (NAM), an amide form of niacin, to evaluate its therapeutic efficacy. NAM treatment modulated NAD