Aim: Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis and constitutes approximately 20- 40% of all extrapulmonary tuberculosis. The gold standard for the diagnosis of active tuberculosis is to perform a culture test. With the advance of molecular techniques, various polymerase chain reaction (PCR) methods have been introduced to identify Mycobacterium tuberculosis more easily and quickly. With this background scientific knowledge, the following study was undertaken with the general objective to determine the various causes of cervical lymphadenopathy by fine-needle aspiration cytology (FNAC) and to delineate the pathology of tuberculous lymphadenitis in patients of a government-run medical college of West Bengal by FNAC. Methodology: Total 100 cases with clinical suspicion of tuberculous lymphadenitis were aspirated amongst which 14 cases has been excluded. The rest 86 cases, amongst which 43 cases were diagnosed as Chronic granulomatous lymphadenitis,26 cases as tuberculous lymphadenitis and 17 cases as Suppurative lesion. In our study chronic granulomatous lymphadenitis and tuberculous lymphadenitis were regarded as FNAC suggestive of tuberculosis. The suppurative lesion was regarded as FNAC not suggestive of tuberculosis. Cytomorphological features associated with suppurative lesion didn__ampersandsignrsquo;t reliably exclude tuberculous lymphadenitis in our study. Results: Out of 86 cases, 36% showed AFB positivity, and 69 cases of FNAC suspicious of tuberculous aetiology showed acidfast bacilli(AFB) in 42% cases. Out of 86 cases, culture was positive in 69 cases(80.2%). TB Culture was positive in 12(70.58%) cases of the suppurative lesion. The culture was found positive in all the AFB positive cases and out of 55 AFB negative smears, TB culture was positive in 38(69%) cases. Conclusion: So to conclude many of the cervical lymph nodes show suppurative lesion without definite granuloma, however they showed AFB positivity in Ziehl Neelsen stain(ZN smear)/ culture positivity. Therefore these cases should be investigated for acid-fast bacilli(AFB) for proper treatment.