<p><p> Background: Fine needle aspiration cytology (FNAC) is a simple, safe, minimally invasive and outpatient procedure that commonly used in diagnosis of thyroid swellings. Objective: The aim of the present study was to determine the prevalence, sensitivity, specificity and diagnostic accuracy of various thyroid lesions in our institute. Material and Method: This prospective study was conducted in pathology department of our institute for the duration of 1 year (March 2013- April 2014). Total 90 patients were included in study irrespective of age and sex. Aspiration was taken after a written consent, detailed clinical history, physical examination and thyroid function test. FNAC results were compared with final histopathological diagnosis wherever feasible. Result: The most common age group of presentation was 31-40 years with M:F -6.5:1. Out of total 90 cases of thyroid, FNAC revealed 70 cases (77.8%) as benign (Bethesda category 2 ) which comprises of colloid/nodular goitre (53.3%) and lymphocytic thyroiditis (24.5%) and 11 (12.5%) as malignant (Bethesda category 6). 5 cases (5.6%) were reported as follicular neoplasm (Bethesda category 4), 2 (2.2%) as suspicious for malignancy- (Bethesda category 5) and 1 case (1.1%) each as follicular lesion of indeterminate significance (Bethesda category 3) and cystic lesion (non diagnostic – Bethesda category 1). The sensitivity of FNAC in this study was found 70% and specificity was 94.7%. The overall diagnostic accuracy found to be 86.2%. Conclusion: FNAC can use as first line of investigation for diagnosis of thyroid nodule. It is safe, inexpensive, outpatient procedure with high sensitivity, specificity and diagnostic accuracy</p></p>