Background: Lymphadenopathy is a common presenting symptom in various diseases.¹ Lymphadenopathy, which is defined as an abnormality in the size or character of lymph-nodes, is caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node.² Objective: The present study was conducted to evaluate the usefulness of Fine Needle Aspiration Cytology as a diagnostic tool in cases of Malignant Lymphadenopathy. Study design: This prospective study was conducted in the Department of Pathology; Victoria Hospital; Bangalore Medical College Bangalore over a period of 6 months i.e from 1.1.11 to 30.6.11. Material and Methods: No of Fine Needle Aspirations done in this period were 1349. Out of which 74 cases were that of Malignant Lymphadenopathy (involving cervical, axillary, inguinal and generalised group of lymph-nodes). Malignant Lymphadenopathy comprises of both primary and secondary (metastatic) disease. Out of 441 cases of lymphnode fnac, 74 cases were diagnosed as malignant cytologically and clinically. Results: Out of 1349, 74 cases were diagnosed to have Malignant Lymphadenopathy. Of the 74 cases, 5 cases were suspicious of malignancy. The age group involved was between 5-95 yrs. The male to female ratio was 2:1. Among them, there were 9 cases (12.16%) of primary lymphoid malignancy and 60 cases (81.08%) of metastatic malignancy and about 5 cases (6.75%) were suspicious of malignancy. The most common metastatic deposit was of squamous cell carcinoma (58.10%) followed by breast carcinoma (8.10%) and malignant melanoma (4.05%). Conclusion: FNAC remains a useful investigation in diagnosing Malignant Lymphadenopathy with good certainty. It is an economical and convenient alternative to open biopsy.