Background: Peripheral lymphadenopathy (PL) is a common clinical entity in pediatric practice. Essential diagnostic considerations include the age of the patient, the site of the abnormal lymph nodes, the duration of lymphadenopathy, any associated signs or symptoms, the presence or absence of generalized lymphadenopathy, any extra-nodal signs or symptoms, and the presence or absence of splenomegaly and or fever. The critical task in approaching patients with lymphadenopathy is to diagnose nodes likely to be related to benign, self-limited conditions and which nodes indicate malignancy or other serious condition requiring specific treatment. Several studies have attempted to identify various characteristics, which may provide useful information to determine the etiology of lymphadenopathy in children. Still a significant number of patients remain with persistent lymphadenopathy, in which the etiology is unclear. Objectives: To evaluate the clinico pathological picture of peripheral Lymphadenopathy in children. Material and Methods: The research was carried out at the Department Pathology on Pediatric patients in a tertiary care hospital for a period of one year. Total 120 children (<16 years) with significant peripheral lymphadenopathy were studied with FNAC and subsequent biopsy wherever available. Relevant clinical data was analyzed. Results: Most of the participants (39.2%) were 5-10 years age group, predominantly male (55%) most of them (67.5%) residing in rural areas, 45% belong to lower socio-economic class. Most common presenting complaint was neck swelling alone (89.2%). Cervical (70%) was commonest lymph node group involved. FNAC in categorizing different types of lymphadenopathy in children revealed were reactive lymphadenitis was the commonest (66.7%) followed by tubercular lymphadenitis (16.7%). Conclusions: The most frequent cause for lymphadenopathy in pediatric population is reactive hyperplasia followed by tuberculosis. FNAC alone can be useful in establishing diagnosis in large number of cases in proper clinical setting and obviates the need for invasive procedures like surgery.