Background: Enlargement of lymph nodes or lymphadenopathy is one of the ubiquitous clinical presentations of patients attending the outpatient department (OPD). Fine-needle aspiration cytology (FNAC), as the initial investigation, has assumed importance in diagnosing various diseases. It is a cost-effective, reliable, immediate, preliminary, relatively little traumatic procedure compared to open biopsy. However, there is not always a specific diagnosis, thus providing ample information for further management and reducing the amount of open biopsy. Objectives: In the present study, we identified the pattern of diseases in the different anatomical locations of lymph nodes and the role of FNAC in the diagnosis of diseases. Materials and Methods: A two-year study of 920 cases of lymphadenopathy presenting to the Department from January 2016 to December 2017 taken up for our study. FNAC performed using a 23/24 gauge needle and a 20 ml syringe. Four of the prepared smears, two were fixed in alcohol and stained with hematoxylin and eosin and Papanicolaou stain. Two smears air-dried, one stained with Leishman stain, and the other by May-Grunwald-Giemsa (MGG) stain. Special stains like periodic acid__ampersandsignndash;Schiff for mucin (PAS) and Ziehl__ampersandsignndash;Neelsen stain (ZN) stain for acid-fast bacilli (AFB) performed for the diagnosis of peculiar lesions. Results: Most common lesion observed in our study was reactive lymphadenitis (33.26%), followed by granulomatous lymphadenitis (28.15%), tubercular lymphadenitis (17.39%) and metastatic lesions (14.23%). Cervical lymphadenopathy found to be the most common site in our study. Conclusion: Our study highlighted the various morphological patterns and incidence of lymphadenopathy concerning various regions and sex. FNAC as a straightforward, cost-effective, relatively painless, quick, repeatable, and reliable method of investigation for lymphadenopathy and also very useful in developing countries like India where costly investigations are not easily affordable.