Background: FNAC has demonstrated excellent diagnostic accuracy. The present study was conducted to assess diagnostic utility of fine needle aspiration cytology in lymphadenopathy. Materials & Methods: 400 patients of lymphadenopathy were subjected to FNAC using 23-25 G needle & 10 ml syringe and Franzens handle. Biopsy samples were stained with H&E. The aspiration smears were studied to arrive at a probable diagnosis. In the available cases FNAC diagnosis was further correlated & compared with the histopathological diagnosis made from sections stained with H&E. Results: The type of lesion was TBLN in 183, CNSL in 91, NTGL in 22, ANSL in 12, metastasis in 45, lymphoma in 17 and leukemia in 2 cases. Out of 400 patients, males were 188 and females were 212. Most common site was found to be cervical region followed by submandibular lymph nodes with inguinal being the least common site. Cytological features of tuberculosis was epitheloid cell granulomas with necrosis in 101, epitheloid cell granulomas without necrosis in 42, and necrosis in 40 patients. Overall AFB positivity was 31.14% of tuberculous cases. The difference was significant (P< 0.05). Hodgkins lymphoma, non hodgkins lymphoma, and leukemia showed 100% sensitivity and specificity. There was sensitivity- 100 %, specificity- 96.97%, PPV- 90.48%, NPV- 100 %. Conclusion: FNAC is simple, safe, self- reliable, cost effective and less time- consuming outpatient procedure especially in centres where advanced diagnostic techniques are not yet available. It can be used as an initial diagnostic tool for lymphadenopathies.