Background: One of the most common problems among patients attending ENT OPD (particularly female patients) is the thyroid enlargement. Though Thyroid cancer is not common; incidence of Thyroid nodule (Simulating thyroid cancer in appearance) is high. This study was conducted to evaluate efficacy of Fine Needle Aspiration Cytology (FNAC) at Mahatma Gandhi Medical College __ampersandsignamp; Hospital, Jaipur in diagnosing thyroid lesions (benign or malignant) and to compare its advantages __ampersandsignamp; results with histopathology. Method: This retrospective study was conducted in Department of ENT and Head-Neck surgery at Mahatma Gandhi Medical College and Hospital, Jaipur during the period January 2008 to January 2013. In all 282 cases were evaluated by detailed history, thorough clinical examination, ultrasonography (USG) of neck, complete thyroid profile (Serum T3, Serum T4 __ampersandsignamp; Serum TSH) and histopathology of thyroid lesion. Results: In our study, sensitivity and specificity of FNAC was 70.2% and 97.3% respectively (in diagnosing thyroid lesions as benign and malignant). Conclusion: FNAC is safe, less expensive, less invasive and cost effective diagnostic tool in diagnosing thyroid lesions and distinguishing benign from malignant ones.