Background: Enlargement of intrathoracic lymph nodes can be due to a number of causes including infection, inflammation, neoplastic or just nonspecific reactive hyperplasia. Patients with mediastinal lymphadenopathy require accurate diagnosis to determine optimal treatment. In 2002, convex probe endobronchial ultrasound {CP-EBUS} was developed to perform real time endobronchial ultrasound guided transbronchial needle aspiration {EBUS-TBNA}. This is used to obtain cytological and histological samples of lesions. This procedure is highly safe and accurate for the examination and staging of mediastinal and hilar lymph nodes. Methods: An observational study on 55 patients of mediastinal and/or hilar lymph nodes who were subjected to EBUS-TBNA was conducted to assess the diagnostic yield and safety of this procedure. Results: There were 36.4% females and 63.6 % males withmost patients from 61-70 years age group (29.1%) followed by 41-50 years (18.2%). There was a history of Tuberculosis in 7 patients (12.7%) and all were HIV negative. Majority of the patients had single lymph node (81.8%) while 18.2% had multiple lymph nodes. TB was the most common diagnosis in 30.9%, followed by reactive Lymphadenopathy in 29.1 %, malignancy in 23.6% and others in 14.5% cases.Total 26 cases had complications (47.3%), out of which most common was minor bleeding in 17 cases (30.9%),followed by bleeding in 4 cases (7.3%), post-procedure fever in 2 cases (3.6 %). One case had fever, hoarseness of voice and ventricular premature beats (1.8%) each. Conclusion: EBUS-TBNA is a safe procedure for getting tissue diagnosis with minimal invasion in mediastinal and hilar lymphadenopathy. However, the procedure requires expertise.