Background: The identification of palpable breast lumps and the differentiation between benign and malignant lesions are essential aspects of breast healthcare. When patients present with palpable breast lumps at outpatient clinics, it is crucial to provide them with a reliable, efficient, and patient-friendly diagnostic method. This study was designed to assess the diagnostic accuracy of FNAC in distinguishing between benign and malignant lesions in palpable breast lumps, with the added benefit of histopathological correlation. Methods: In this prospective study, a total of 100 patients who presented with palpable breast lumps underwent Fine Needle Aspiration Cytology (FNAC). The FNAC procedure was conducted using a 23G needle to aspirate material from the breast lump. Subsequently, the aspirated material and histopathological sections were stained with Hematoxylin and Eosin (H&E) for microscopic analysis. The cytological diagnosis obtained from FNAC was meticulously compared with the results of histopathological examination. To assess the diagnostic accuracy of FNAC, various parameters including specificity, sensitivity, accuracy, and predictive values were calculated using established standard formulas. Results: This study revealed that fibroadenoma was the most common benign lesion, while infiltrating ductal carcinoma emerged as the most prevalent malignant lesion among the patients with palpable breast lumps. The diagnostic accuracy of Fine Needle Aspiration Cytology (FNAC) in this study was calculated at 86.6%. FNAC demonstrated an overall sensitivity of 87.71% in diagnosing palpable breast lumps. Moreover, it exhibited excellent specificity at 100%, a positive predictive value of 100%, and a negative predictive value of 93.55%. These findings underscore the utility of FNAC as a reliable and accurate diagnostic tool for distinguishing between benign and malignant breast lesions, offering high sensitivity and specificity. Conclusion: The diagnostic effectiveness, sensitivity, and specificity demonstrated by Fine Needle Aspiration Cytology (FNAC) in this study were found to be in line with those obtained through histopathological examination. Consequently, FNAC emerges as a valuable and trustworthy first-line diagnostic method for the preoperative diagnosis of both benign and malignant breast lesions. Furthermore, the study uncovered a positive correlation between the Robinson cytological grading system used in FNAC and the Scarff-Bloom-Richardson histological grading system, strengthening the reliability and consistency of FNAC as a diagnostic tool for assessing breast lesions.