Introduction: The development of aspiration cytology is one of the biggest advances in anatomic pathology. Cancer has become one of the 10 leading causes of death in India. Head and neck neoplasia is a major form of cancer in India, accounting for 23% of all cancers in males and 6% in females. The advantages of fine needle aspiration cytology (FNAC) are: it is safe, sensitive and specific for the diagnosis of malignancy, gives a rapid report, requires little equipment, causes minimal discomfort to the patient, is an out patient procedure, repeatable and cost effective avoids the use of frozen section, reduces the rate of exploratory procedures and allows a definitive diagnosis of inoperable cases. FNAC is of particular relevance in head and neck lesions because of easy assessibility, excellent patient compliance, minimally invasive nature of procedure and helping to avoid surgery in non-neoplastic lesions, inflammatory conditions and also some tumors.