To describe fine needle aspiration cytology of mycetoma and determine its usefulness in diagnosis.The study group consisted of 14 patients with different types of mycetoma lesions, which were aspirated. Smears were reviewed without knowing the type of mycetoma, and the findings were compared with those observed in histologic sections.In mycetoma, the causative organisms have a distinct appearance on cytologic smears. They are surrounded and infiltrated by neutrophils in a background of polymorphous, inflammatory cells consisting of neutrophils, histiocytes, lymphocytes, plasma cells, macrophages and foreign body giant cells. This allows differentiation from artifacts and inflammatory lesions caused by other bacteria and fungi. The distinction between eumycetoma and actinomycetoma in fine needle aspiration cytology was found to be as accurate as is histopathology when the grains were present.These results demonstrate that mycetoma can be accurately diagnosed by fine needle aspiration cytology. The technique is simple, inexpensive, rapid and sensitive. It can be used in the routine diagnosis of mycetoma, in epidemiologic surveys and in material collection.