Background: There are instances when either we do not perform pre-operative biopsy due to the fear of spread of malignancy, or needle aspiration cytology is inconclusive. During surgical exploration for a benign pathology if surgeons find suspicious lesions, per-operative cytological diagnosis becomes important to rule out malignancy. The frozen section facility is available only at few large volume centres. So there is always a need for an easy and cheap alternative to frozen section that can help surgeons at low volume centres as well. Aim: Aim of the study was to assess the reliability of imprint cytology in per-operative (immediate) diagnosis of malignancy. Material and methods: The present study was a prospective analysis of 69 specimens from suspected or diagnosed cancer patients that were sent for per-operative (or urgent) imprint cytology (IC) from July 2012 to Feb. 2014, at surgical oncology unit of our institute. All the specimens were then subjected to paraffin section (PS) and final reports were compared. Results: Out of 69 specimens 61 were found to be malignant, and five were found to be benign by both IC and PS. In all such situations IC helped us a lot in decision making regarding change in treatment plan further. The sensitivity and specificity of imprint cytology were 96.8 % and 83.3% respectively. The positive predictive value (PPV) of IC was 98.3 %. Conclusions: The imprint cytology is a cheap and reliable method for per-operative diagnosis of malignancy. It can be used for per-operative confirmation of parathyroid glands before auto-implantation.