Oral lesions usually lead to a diagnostic dilemma. Fine needle aspiration cytology (FNAC) is an important diagnostic aid for making a preoperative diagnosis of oral lesions. It does not supplant histopathology but augments it. FNAC of oral lesions was undertaken in 45 patients, and all the lesions were subjected to histopathologic examination. Aspiration was performed with 23- to 25-gauge needles held in a Cameco syringe holder (Amar Udyog, Chandigarh, India). We diagnosed benign lesions in 22 cases, malignant lesions in 15, and inflammatory lesions in 7 by FNAC, whereas in 1 case the specimen was insufficient for diagnosis. One result was false negative, but there was no false-positive result. Specificity and sensitivity of FNAC were 95.45% and 93.75%, respectively. FNAC gave a diagnostic accuracy of 90.0% for benign lesions, 94.0% for malignant lesions, and 100% for inflammatory lesions. The procedure does not have any side effects or complications. Hence FNAC can be used as a reliable diagnostic aid for oral lesions because it is safe, accurate, convenient, and cost-effective.