Background: Fine needle aspiration cytology (FNAC) is a valuable adjunct to pre-operative screening in the diagnosis of thyroid nodules, and in most cases, it can distinguish between benign and malignant lesions. Aim: To study the cytology of neoplastic thyroid lesions to minimize surgical intervention and for confirmation of the diagnosis by histopathological study. Materials and Methods: 100 cases of thyroid FNAC smears were analyzed and cyto-histopathological correlation was done in 47 cases. Galen and Gambino′s method was used to calculate the sensitivity and positive predictive value. Results: Of the 100 cases, 90 were diagnosed as neoplastic lesions by FNAC and ten cases as non-neoplastic lesions, which turned out to be neoplasms on histopathological study. Among 100 cases, 47 were biopsied and subjected to histopathological study. The sensitivity of FNAC was 75.60%, and positive predictive value was 83.78% for malignant lesions. Conclusions: FNAC is a rapid, efficient, cost-effective, relatively painless procedure with a high diagnostic accuracy. It has high rate of sensitivity and positive predictive value in diagnosing thyroid neoplastic lesions. Hence, it is a valuable tool in the diagnosis and management of patients.