Background: Thyroid nodules are an extremely common disorder. Fine Needle Aspiration (FNA) is the gold standard procedure for thyroid nodules diagnosis and management; it helps clinicians to make a proper therapeutic decision and minimizes the need for unnecessary surgery.Objective: To assess thyroid FNA sensitivity, specificity, accuracy, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) in Al-Assad University Hospital using the Bethesda system for reporting thyroid cytology. Methods: We prospectively followed thyroid FNAs, then the histological results were followed after performing surgery. FNA was performed by endocrinologists in al-Assad and al-Mouwassat university hospitals, and the cytological study for all samples was performed in pathology department at al-Assad university hospital. All available data were analyzed with SPSS version 23 statistical program.