Introduction: Fine Needle Aspiration Cytology (FNAC) is well accepted as a safe, reliable, minimal invasive and cost effective method for preoperative diagnosis of salivary gland lesions. Aims and Objectives: The aim of this study is to evaluate diagnostic accuracy, sensitivity and specificity of FNAC in various salivary gland lesions in correlation with their histopathology, which helps in the appropriate therapeutic management. Materials and Methods: A total of 88 FNACs were done on salivary gland lesions from January 2013 to November 2013 in the Pathology Department of one of the largest government tertiary care teaching hospital, Ahmedabad (Gujarat, India). Formalin fixed (10%), surgically resected specimens were received, they were processed and slides were prepared for histopathological diagnosis. The stained cytological and histopathological slides were studied, analyzed and correlated. Results: Our study included 88 patients who underwent preoperative FNAC for salivary gland lesions with subsequent surgical excision. Out of 88, 52 (59.1%) were males and 36 (40.9%) were females. Male to female ratio was 1.4: 1. The median age was 42 years. Parotid gland was involved in 60 (68.2%) cases, submandibular in 26 (29.55%) cases and other minor salivary glands in 2 (2.27%) cases. Out of 88, 79 cases (89.8%) were cytologically diagnosed as benign lesions and 9 (10.2%) were malignant. The most common benign cytological diagnosis was pleomorphic adenoma; 41 out of 79 cases (51.9%). Cytological diagnoses were compared with histopathological ones and were true-negative in 77 (97.5%), true-positive in 8 (88.9%), false-negative in 2 (11.1%) and false-positive in 1 (2.5%) cases regarding detection of malignant tumors. The overall cytological diagnosis achieved a sensitivity of 80%; a specificity of 98.7%, Positive Predictive Value of 88.9%, Negative Predictive Value of 97.5% and diagnostic accuracy of 96.6%. Conclusion: This study indicated that FNAC of salivary gland is a reliable and highly accurate diagnostic method for diagnosis of salivary gland lesions. It not only provides preoperative diagnosis for therapeutic management but also can prevent unnecessary surgery.