BACKGROUND: – The evaluation of a neck mass is a common clinical dilemma and a condition to which an ENT clinician routinely encounters. . In the head and neck region, FNAC is of great value because of the multiplicity of accessible organs and heterogeneous pathologies encountered. An early differentiation of benign from malignant pathology greatly influences the planned treatment. The purpose of this study was to evaluate the adequacy and accuracy of FNAC in diagnosis of neck mass. AIMS AND OBJECTIVES: – to know the commonest cause of neck swellings in the study area, and to compare the accuracy of FNAC over open biopsy. METHODOLOGY: – It is Descriptive, observational, hospital based study. Study conducted in out–patient department R.V.M hospital, R.V.M MEDICAL COLLEGE, Laxmakkapally, Siddipet, Telangana, from DEC 2017 to NOV 2018 for a period of 1 year. All patients attending ENT OPD with neck swelling of both sexes and all age group were included with 100 sample size. RESULTS:– Most of the study population belongs to 31–40 years, Mean age is 34.25 years and Male predominance (74%).Neck swellings were asymptomatic, most common site was midline. Lymph nodes (43%), thyroid swellings (41%) were majority among all.Average Sensitivity of 66.32%, and specificity of 70.40% recorded with FNAC. CONCLUSION; – FNAC is proved to be the promising diagnostic tool with less discomfort and minimal trauma when compared with biopsy.