Background: The thyroid is a butterfly-shaped gland located in the front of the neck just above the trachea. Fine-needle aspiration cytology (FNAC) is a well-established technique for preoperative investigation of thyroid nodule. The present study was conducted for assessing occurrence of thyroid lesions with the aim of assessing cytological features of FNAC aspirateof thyroid swellings. Materials: Patients were clinically examined & careful palpation was done to guide precisely the location. Fine needle aspiration (FNA) was done with a 23-gauge needle attached to a 20-cc airtight disposable syringe fitted in a syringe holding FNA Gun which provides better grip and negative pressure to aspirate adequate sample. The sample was obtained by to and fro motion. Samples were smeared onto glass slides and fixed in 95% methanol, along with one or two air-dried smears. In cystic lesions, after aspiration of fluids, the lesion was again aspirated. The fluid was centrifuged and smears are made from sediment. Wet-fixed smears were stained with Hematoxylin and Eosin (H and E). All the results were recorded in Microsoft excel sheet and were subjected to statistical analysis using SPSS software. Results: 546 patients were evaluated. Among them, 252 had non-neoplastic lesions, 192 had neoplastic lesions, 93 had inflammatory lesions and the remaining 9 had development lesions. Among non-neoplastic pathologies, simple goiter was seen in 78.57 percent of the patients while nodular colloid goiter was seen in 19.84 percent of the patients. Sensitivity and specificity of FNAC of non-neoplastic lesions with histopathology was 91.8 percent and 89 percent respectively. Sensitivity and specificity of FNAC of inflammatory lesions with histopathology was 86.6 percent and 95 percent respectively. Sensitivity and specificity of FNAC of neoplastic lesions with histopathology was 92 percent and 97 percent respectively. Conclusion: FNAC is therefore an invaluable and minimally invasive procedure for preoperative assessment of patients with thyroid nodules. It has high sensitivity and diagnostic accuracy in evaluation of thyroid nodules.