Abstract: The goal of this study was to evaluate the diagnostic value of FNAC in the diagnosis of the thyroid swellings. Fine needle aspiration cytology is the unique tool for the pre-operative decision-making of the thyroid swellings. This research work was performed at the department of pathology, MGM Medical College and Hospital, Jamshedpur, Jharkhand. This was cross-sectional comparative study. The period of the study was two years from March, 2014 to February, 2016. The study group constituted of 112 patients presenting with thyroid swelling attending a tertiary care centre in MGM Medical College and Hospital, Jamshedpur, Jharkhand. FN aspiration were carried out in all cases and compared with surgical biopsies taking as goal standard. FNAC was done on total of 112 cases of the thyroid swellings. Females outnumbered males with a ratio of 3:1(85females and 27 males). In the FNAC, maximum cases (75.90%) were of colloid goitre, follicular carcinoma was found in 7.14% and anaplastic carcinoma in 3.57% of cases. Microscopical examination of stained tissue sections showed predominantly colloid goitre (72.32%) and then follicular carcinoma (8.04%). The overall incidence of malignancy was 11.61% diagnose by HPE and 9.82% by FNAC. FNAC is a primary diagnostic device for the pre-operative screening of thyroid swellings. It is simple, safe, reliable, minimally invasive, and cost effective.