BACKGROUND Most of the thyroid swellings are non-neoplastic and with normal thyroid hormone. So, it doesn't require any surgical excision, even though the thyroid swelling is an indication for surgical excision. The present study was done to evaluate the accuracy of fine needle aspiration cytology (FNAC) for the thyroid swellings and correlate it with the histopathological findings. METHODS This is a prospective study. A total of 47 cases were studied. Fine needle aspiration cytology was done, slides were made and studied. Histopathological examination of the corresponding 47 cases was also done and correlated with FNAC findings. Sensitivity, specificity and accuracy were calculated. RESULTS Age of the patients varied from 20 - 69 yrs. Most of them were in the age group of 30 - 39 years and 50 - 59 years. The ratio of male to female was 1:4.9. Swelling of the neck was the most common presentation in most of the patients. On FNAC 33 (70.2 %) cases were diagnosed as colloid nodular goitre, 04 (8.5 %) as autoimmune thyroiditis, 08 (17.0 %) as follicular neoplasm, 01 (2.1 %) as suspicious of malignancy, 01 (2.1 %) as papillary carcinoma. On histopathological examination 25 (53.2 %) cases were diagnosed as colloid nodular goitre, 01 (2.1 %) as fibrous thyroiditis, 01 (2.1 %) as Graves’ disease, 07 (14.9 %) as Hashimoto’s’ thyroiditis, 06 (12.8 %) as follicular adenoma, 01 (2.1 %) as follicular carcinoma, 04 (8.5 %) as papillary carcinoma and 02 (4.2 %) as NIFTP (noninvasive follicular thyroid neoplasm with papillary like nuclear features). The overall sensitivity was 69.2 %, specificity was 97.0 % and accuracy was 89.3 %. CONCLUSIONS FNAC is a minimally invasive, highly accurate and cost-effective procedure. FNAC helps the clinician to diagnose malignant lesions with confidence. It has high rates of specificity and accuracy but comparatively has less sensitivity. However, it is very important for the management of patients with thyroid swelling. KEYWORDS Fine Needle Aspiration, Prospective Study, Sensitivity, Specificity, Thyroid Swelling