Background and Objectives: Fine needle aspiration cytology (FNAC) is a part of triple assessment in evaluation of breast lesions in our country. In the western countries, core needle biopsy (CNB) is fast replacing FNAC as part of screening programmes and early detection of cancer. This study was undertaken to know the advantages, limitations of each procedure and their diagnostic utility in patients in and around Bangalore. Methodology: 50 female patients presenting with breast lesion were subjected to both FNAC and CNB. Grades were assigned as C1-C5 for FNAC and B1-B5 for CNB. Statistical analysis was done using kappa correlation score and the concordance rate between the two procedures was determined. Results: The most common age group was between 21-40 years and left sided lesions were more common. Out of 50 cases, there was concordance between FNAC and CNB in 38 cases and 12 cases were discordant. Kappa score of agreement was 0.559 indicating a moderate degree of concordance between the two tests. Conclusion: Both FNAC and CNB are equally good in assessment of breast lesions. However, FNAC is more suitable in the developing counties, for palpable lesions due to better turnaround time and it is cost effective. Whenever there is discrepancy between clinical findings, imaging studies and FNAC, CNB can be used as the next step in assessment before definitive treatment. Also, it can be used in cases of low grade malignancies, where it is difficult to give a diagnosis of malignancy on FNAC alone.