Lymphadenopathy is of great clinical importance as it may be the first indication of a readily manageable conditions reactive lymphadenitis, lymphoma and metastatic carcinoma. Fine needle aspiration cytology (FNAC) has been established as the initial diagnostic technique of choice but it still has it diagnostic pitfalls and in difficult cases biopsy may be required for confirmation.  In this study we have reported the patterns of cytological diagnosis if fine needle aspiration cytology (FNAC) of 2424 clinically diagnosed cases of cervical lymphadenopathy over a period of three years at Jawahar Lal Nehru Medical College, Ajmer (Rajasthan). Histological correlation was available in 400 cases. Of the total of 2194 cases included in the study, we concluded that tuberculosis was the most common benign cause of enlarged neck nodes, while metastatic malignancies comprised majority of the malignant lymphadenopathy cases. This study highlights the usefulness of FNAC as a simple, inexpensive, relatively painless, rapid, repeatable and reliable method of investigation for lymphadenopathy.