Introduction: Goiter is a common problem in southern Punjab and thyroid surgery is frequently performed in surgical units of BVH Bahawalpur. Fine Needle Aspiration Cytology is the investigation of choice in detection of carcinoma thyroid. It is simple and quick to perform and can be readily repeated. Objectives: The aim of the study was to find out the diagnostic accuracy of FNAC in thyroid nodules. Study Design: Cross sectional study. Period: June 2009 to November 2009. Setting: Department of Surgery, BVH Bahawalpur. Methods: Fifty patients of goiter of age ranging from 16to60 years, irrespective of gender, presenting with a thyroid nodule and undergoing surgery were included in the study at Department of Surgery, BVH Bahawalpur. Information of each patient was collected on a structural Performa and then analyzed on SPSS to assess the sensitivity and specificity of the FNAC. Results: the sensitivity and specificity of FNAC was 72.2% and 97.8% respectively. Conclusions: FNAC should be performed in all cases of thyroid nodules because of its high sensitivity and specificity to diagnose the benign as well as the malignant lesions of thyroid.