Background: Lumps in breast have always commanded a great deal of attention because of fear of their being cancerous. Preoperative diagnosis helps in planning the correct surgical and therapeutic treatment. Aim: This study was aimed to assess the efficacy of Fine Needle Aspiration Cytology (FNAC) in breast lump evaluation with regards to sensitivity, specificity, positive predictive value and negative predictive value. Materials and Methods: This study was carried out on 277 breast lump cases at the Department of pathology, Dr. Hedgewar Arogya Sansthan Hospital from July 2009 to July 2010. FNAC was performed by cytopathologist with a 21 or 22G needle that was attached to a 10cc syringe. Two slides were stained with May Gr__ampersandsignuuml;nwald-Giemsa (MGG) and 2 with Papanicolaou (Pap) stain. FNAC results were compared with final histopathological diagnosis. Taking histopathology as gold standard criteria, sensitivity, specificity, positive predictive value and negative predictive value of FNAC for detection of various lesions were calculated. Results: A total of 277 cases of FNAC of breast Lumps were obtained, out of which histopathological correlation was available in only 31 (11.19%) cases. Out of 12 histopathologically confirmed malignant cases, 8 cases were diagnosed as malignant on FNAC, two cases as suspicious for malignancy, one case as atypical hyperplasia and one as benign mammary lesion. There was not even a single case which was diagnosed as malignant on FNAC and later turned out to be benign on histopathology. Out of 31 cases where histopathology was available, in 28 cases the FNAC diagnoses correlated well with the final histopathological diagnosis. In the remaining 3 cases, one was diagnosed as benign mammary lesion and others as atypical hyperplasia on FNAC. On histopathological examination all 3 showed infiltrating ductal carcinoma. The Sensitivity, Specificity, Positive predictive value and Negative predictive value of FNAC were found to be 90.32%, 100%, 100% and 86.36% respectively. Conclusion: FNAC is a quick, inexpensive, simple, safe and readily acceptable procedure to patient and can be performed in Out Patient Department. It helps in providing a speedy and accurate diagnosis of not only breast cancers but also the majority of benign lesions mimicking malignancy.