Background: Fine needle aspiration cytology is a diagnostic tool in which cells are extracted from palpable swelling using FNAC gun or syringe and needle. It is a simple, speedy, safe, cost effective and accurate technique being used worldwide. But, pitfalls come along making the correlation with histopathology often necessary. Materials and Methods: This study was a prospective study conducted among 30 patients undergoing thyroidectomy for thyroid swellings in ENT department, Bangalore Medical College and Research Institute, Bangalore. Patients were evaluated by detailed history, clinical examination, preoperative FNAC, thyroid function tests. Results: Thirty patients who underwent thyroidectomy for thyroid swelling during the study period was selected. Among 30 cases all specimen was sent for gross and microscopic examination. Two cases of malignant neoplasms were detected, one of which was benign according to FNAC. Most common lesion was multinodular goiter. Correlation of FNAC and histopathology for benign and malignant lesions, sensitivity of FNAC was found to be 50%, specificity 100%, negative predictive value of 96.5 % and positive predictive value of 100%. p-value<0.01, showing that there is a strong positive correlation between FNAC and histopathology findings. Conclusion: Thyroid pathologies are frequently encountered in otolaryngology clinics. Often the initial FNAC is a cost effective and minimally invasive procedure for the preoperative assessment of patients with thyroid swelling. Even though the clinical presentation may be similar in benign and malignant thyroid swellings, FNAC is the key to initial evaluation of thyroid swellings as well as to plan the surgery. Keywords: Fine Needle Aspiration Cytology, Histopathology, Thyroid swellings.