Introduction: The initial screening procedures include ultrasonography, fine needle aspiration cytology (FNAC). An initial screening test which will diagnose thyroid lesions accurately will help to avoid surgery in nonneoplastic conditions. Aim: The aim of the present study is to correlate the ultrasonography findings corresponding TIRADS categories with cytology findings corresponding to intermediate Bethesda categories to check diagnostic accuracy. Materials and Method: The present prospective study comprised of 50 patients who were having solitary thyroid nodule detected either on clinical examination or radiologically with thyroid nodule. All the patients were subjected to ultrasound examination of the thyroid gland and fine needle aspiration (FNA) of the nodule was at the same day. Comparative analysis of efficacy of TIRADS in differentiating benign from malignant nodules and thyroid cytopathology reporting under the bethesda grading system was conducted. Data was assessed finally accuracy, and statistical analysis was made with Chi-square tests. Results: There is a good concordance between ultrasonography findings using TIRAD criteria and FNAC using Bethesda to evaluate thyroid nodule in benign lesions. However, discordance in detection of malignancy was found between TIRADS 4 and Bethesda IV. Conclusion: The possibility of a particular nodule being malignant can be effectively deduced from the ultrasound-based TIRADS system. The nodules which appeared suspicious on ultrasound to be classified under TIRADS 4 and TIRADS 5 further need FNAC examination.