Gallbladder carcinoma is the one of the most common malignancy, comprising of 80–95% of biliary tract cancers. Ultrasonography-guided fine-needle aspiration cytology (USG-FNAC) seems to an effective diagnostic the tool for the accurate diagnosis of gallbladder lesions, however data on its diagnostic utility and cyto-morphological categorization of gallbladder lesions are still lacking. Aims: To study the diagnostic usefulness of USG-FNAC in gallbladder lesions. Materials and Methods: This is retrospective study, done in tertiary health care center in which USG FNC diagnoses were correlated with histo-pathological and clinical follow-up, to assess the diagnostic accuracy. A total of 104 USG -FNCs that were performed between 1st of January 2018 to 31st of March 2022 were reviewed. Results: Out of 105 cases, n=21 cases (10.5%) were -inadequate/non-diagnostic.The mean age was 52 years, with a range of 44–78 years. Women predominated over men (Male:Female=1:2). Primary adenocarcinoma of the gallbladder was most common. On cyto-histological correlation, the sensitivity, specificity, and diagnostic accuracy of USG-FNAC of gallbladder lesions were found to be 97.82, 89.23, and 98.31%, respectively. Conclusion:USG FNAC techniques ensures satisfactory diagnostic accuracy specially in malignant conditions of gallbladder lesion. Other advantages are such as minimum invasiveness, rapidity, and cost effectiveness. Hence, helps in appropriate management of patients thus avoiding unnecessary morbid surgeries.