Background and objective: To evaluate the role of fine needle aspiration cytology in diagnosis of lymphadenopathy in HIV infected patients and to find out the correlation between cytological findings and CD4 count. Material and methods: It is a hospital based cross sectional study for 2 years (January 1999 to December 2011). Patients having lymphadenopathy with HIV infections were included in the study. FNAC of the lymph node(s) were done and from the aspirates, the smears were made and air dried and fixed in 95% ethyl alcohol. Slides were stained routinely with MGG and AFB or other special stains. CD4+ T cell was counted using Fluorescent activated cell sorters. Descriptive statistics and significance testing were carried out by using ANOVA and Post hoc test. Results: The mean age of presentation was 31.38 years. NSRL (42.1%) was the most common lesion followed by tubercular lymphadenitis (38.84%). Granulomatous lymphadenitis (9.92%), acute suppurative lymphadenitis (6.61%) and one case (0.83%) each of NHL, metastatic lymph node and fungal (P. marneffei) lymphadenitis were the other cytological diagnoses. Maximum number of cases was associated with CD4 count range 101-200 (43.8%). Conclusion FNAC is reliable, safe, cost effective procedure for diagnosis of lymphadenopathy in the entire spectrum of HIV infection.