Introduction: Fine Needle Aspiration Cytology (FNAC) of neck masses is a quick, easy, safe and cheap technique and has been a well accepted procedure in diagnosing various swellings. In head and neck regions FNAC is widely used such as in the lymph nodes, thyroid, salivary glands and other neoplasms. Aims and Objectives: 1.To evaluates the role of FNAC and its utility in diagnosis of palpable head and neck masses; 2. To study the spectrum of head and neck lesions in rural population; 3. To study diagnostic accuracy of FNAC by histopathological correlation wherever possible. Materials and Methods:The present study includes 706 cases of palpable head and neck swelling in department of pathology of tertiary care centre from January 2016 to June 2017. Aspiration was done and cytological diagnosis was given. Cytohistopathological correlations were done wherever possible. Result: Total 706 patients of palpable head and neck lesions studied out of that lymph node (33.00%) was common site followed by, thyroid lesion (30.31%), miscellaneous (22.80%) and salivary gland (13.88). Most common nonneoplastic, benign neoplastic and malignant neoplastic lesion is reactive lymphadenitis, colloid goiter of thyroid and metastasis of squamous cell carcinoma in lymphnode respectively. Accuracy rate of FNAC in 70 cases which are correlated with histopathological examination was 95.71% with sensitivity and specificity of 78.57% and 100% respectively. Conclusion: Fine needle aspiration cytology is simple, rapid and safe diagnostic tool with accuracy of 95.71% for differentiating neoplastic from nonneoplastic lesions of palpable head and neck region.