Introduction:Breast carcinoma (BC) is most popular in females, and it has exceeded lung carcinoma. Cytopathological analysis plays a crucial role in the diagnosis and management of breast lesions. The Yokohama System offers a standardized approach to categorizing breast lesions, aiding in treatment decisions. It is also used as a therapeutic method for management.Aim:The aim of this study is to categorize breast lesions using the International Academy of Cytology (IAC) Yokohama system and to correlate with the histopathology report.Materials and Methods:A retrospective examination of cytopathological data from breast lesions collected between January 2021 and December 2023 at Shantabaa Medical College & General Hospital in Amreli was carried out. Fine needle aspiration cytology (FNAC) specimens were classified according to the Yokohama System categories. Two pathologists reviewed the cytology and histopathology slides from studies carried out retrospectively over three years at a single center.Results: The maximum number of cases falls into the age distribution between 36 and 45 years (32 cases, 31.07%), with an increased number of cases in the upper outer quadrant (55 cases, 53.40%), and from all cases the maximum number of cases fall into the benign category (49 cases, 47.57%). In our study, the risk of malignancy (ROM) was 100% in category V, 94% in category IV, and 0.5% in category III.Conclusion:The utilization of the Yokohama System in cytopathological analysis of breast lesions at our tertiary institute showed promising results in categorizing lesions and guiding subsequent management decisions. The high concordance rate between FNAC and histopathological findings underscores the reliability of this approach. Further studies are warranted to validate these findings and explore the clinical implications in diverse healthcare settings.