Introduction: Head and neck lesions comprises a large number of congenital, inammatory or neoplastic lesions including different anatomic sites and originating in different tissues and organs. Fine needle aspiration cytology (FNAC) is a simple, quick, feasible, repeatable and outpatient procedure with minimal risk of complication. Aim: To study the role of FNAC and its utility in diagnosis of palpable head neck masses and to determine the spectrum of various lesions. Materials And Methods: A retrospective study was conducted in pathology department of Shaheed Nirmal Mahato Medical College, Dhanbad, Jharkhand from January 2016 to December 2020 on patients with palpable head and neck swelling. Detailed clinical history of patient was noted. Aspirations were done by using 10 ml syringe and 22/23 gauge needles. Smears were stained with PAP, Haematoxylin and Eosin and Leishman stain. Cytomorphological diagnosis was given. Results: Out of 562 patients of head and neck swelling, 61.92% (348 cases) were of lymph node, 20.28% (114 cases) were of thyroid, 3.38% from salivary gland (19 cases), 14.06% (79 cases) from skin and soft tissue swellings. The most common diagnosis was reactive lymphadenitis (32.74%) followed by granulomatous lymphadenitis (18.33%). The mean age of study population was 32 years. There was female preponderance (88.59%) in thyroid lesions whereas lymph node lesions (60.91%), salivary gland lesions (73.68%) and soft tissue swellings (59.49%) were more common in males. Conclusion: From our study we concluded that FNAC is simple, quick, inexpensive, repeatable and minimally invasive rst line investigation for differential diagnosis of head and neck lesions.