Among Asian women, thyroid swelling is common problem. Fine needle aspiration cytology (FNAC) is widely used to categorize the thyroid swelling between benign and malignant condition. To streamline the reporting of thyroid aspirate Bethesda system was introduced. In this study, we evaluated this disease, spectrum of thyroid cytopathology and correlated with histopathology. The study was conducted in pathology department of tertiary health care. FNAC of thyroid swelling was done in 160 patients. Out of these 48 patients subsequently underwent surgical excision. Cytological diagnosis was correlated with final histopathological result.