The aim of the study: the present study is to evaluate the accuracy of fine needle aspiration cytology (FNAC) of thyroid swellings and to correlate with histopathological findings to avoid unnecessary surgeries for benign lesions. Methods: this is a prospective study. A total of 55 cases were studied in the Department of Pathology at A.C.S Medical College and Hospital. Fine needle aspiration cytology was done and correlated with histopathological examination. Sensitivity, specificity, and accuracy were calculated. Results: majority were noted among 41-50 years (60 %). Females i.e., 78.1 % (43/55) outnumbered males 21.8 % (12/55). Solitary nodule thyroid in Right lobe is 54.5 % (30/55) and left lobe is 45.4 % (25/55). In the present study 65.4 % (36/55) presented with symptoms for 1month – 1 year. Non neoplastic lesions constituted 76.3 % (42/55) in our study on FNAC. Among non-neoplastic lesions, nodular goiter was most reported and constituted 36.6 % (20/55). Neoplastic lesions constituted 23.6 % (13/55) and among neoplastic lesions follicular neoplasm occupied 9.09 % (05/55). Nodular goiter was most reported and constituted 29.0 % (17/55). Follicular adenoma occupied 20 % (11/55), 9.09 % (05/55) as PTC and 5.4 % (02/55) reported as follicular carcinoma. 1.8 % (01/55) each reported as medullary carcinoma and anaplastic carcinoma. Non-neoplastic lesions constituted 76.3 % (42/55) in our study on FNAC and neoplastic lesions constituted 23.6 % (13/55). Conclusion: FNAC is a minimally invasive, highly accurate and cost-effective procedure. FNAC helps the clinician to diagnose malignant lesions with confidence. It has high rates of specificity and accuracy but comparatively has less sensitivity to diagnose the solitary thyroid nodule. However, it is an important diagnostic tool for further management of patients with thyroid swelling