Backgroud: Palpable head and neck lesions (PHNL) comprise a common clinical entity and have a wide etiological profile that includes various non-neoplastic and neoplastic lesions of lymph node (LN), salivary gland, thyroid gland and soft tissue.In the last few decades, FNAC has emerged as a useful modality for evaluation of head and neck masses. Hence, the present study was planned with an aim to assess the role of FNAC in evaluation of palpable head and neck lesions. Material and methods: This study was conducted among 278 patients of all age groups presenting with palpable head and neck swelling. FNAC was performed using 10 ml disposable syringe with 23-25 gauge needle under all aseptic precautions. Smears were prepared, stained and observed under microscope. Results: In the present study, out of 278 patients presenting with palpable head and neck swelling, 134 (48.2%) patients were females and 144 (51.8%) were males. Maximum number of patients were aged between 31 and 40 years (24.8%) followed by those aged 21-30 years (21.2%). The findings of the study revealed lymph nodes and thyroid gland to be the most commonly involved sites with a dominance of inflammatory lesions. Reactive lymphadenitis was the most common inflammatory lesion, colloid goiter was the commonest benign diagnosis and metastatic SCC was the most common malignancy diagnosed. Conclusion: The findings of the present study showed that FNAC is simple, quick, inexpensive and minimally invasive first line investigation for diagnosis of palpable head and neck lesions. The findings confirmed the utility of FNAC as a preliminary screening tool that could facilitate the final diagnosis and management of the patients and helps in avoiding unnecessary surgical interventions.