Fine Needle Aspiration Cytology (FNAC) of thyroid has been introduced as the most reliable and cost effective method for diagnosing of clinically important thyroid disorders. The aim of our study is to assess various cytomorphological lesions of thyroid gland and diagnostic dilemmas related to them. A total number of 347 cases were included in the study. Only patients which had a solitary or multiple thyroid nodules were selected for FNA. The FNAC results are classified as benign, malignant, suspicious, and unsatisfactory. A total of 347 cases of thyroid swellings were aspirated during the study period. Among the reported cases female outnumbered the male patients and maximum thyroid lesions were in age group 21–40 yrs. Colloid goiter was prevalent among all age groups whereas anaplastic carcinoma was diagnosed in age group >50 yrs. Majority of cases reported on cytology were non neoplastic. Fine needle aspiration cytology is a rapid, inexpensive OPD procedure for pre operative evaluation of patients with thyroid swellings and should be promoted by clinicians as primary modality in the evaluation of thyroid lesions.