Introduction: Lump in the neck is the most likely clinical problem to be encountered. Fine needle aspiration cytology (FNAC) is found to be simple, safe, cheap, OPD based procedure which is very useful in diagnosing cervical lymphadenitis, which are superficial and easily accessible, and have very little cosmetic damage. Aims: To diagnose various cervical lymph node lesions by FNAC and to correlate FNAC findings clinically and histopathologically. Material and method: This two years prospective study was done in department of Pathology in tertiary care center. A total of 234 FNAC were included in this study. Detailed clinical history, physical examination and investigations were recorded. Results: Out of 234 cases of cervical lymph node aspiration, maximum belonged to nonneoplastic category, followed by malignant lesions in 20 cases. Tuberculous lymphadenitis was the most common non neoplastic lesion encountered in 102 cases (48.11%). Malignant lesion were detected in 20 cases (8.54%), in which metastatic squamous cell carcinoma accounted for 12 cases, followed by adenocarcinoma (2 cases) and lymphoma (6 cases). Thus, FNAC plays an important role in separating inflammatory lesions from cystic and neoplastic lesions in which no surgical excision is required. Early specific diagnosis allows prompt and appropriate treatment.