BACKGROUND Fine-Needle Aspiration Cytology (FNAC) is a widely used method, which is accurate and safe in a readily palpable masses. But, in those inaccessible lesions and deeper organs are safely aspirated using fine needle radiological procedure like ultrasound or computed tomography guided. The aim of the study is to assess the utility of FNAC in the diagnosis of intra-abdominal lesions and different pattern of lesions in particular to the sites. MATERIALS AND METHODS This retrospective study was done in the Department of Pathology, Regional Institute of Medical Sciences (RIMS), Imphal, between June 2010 and June 2016. The study included 128 intra-abdominal masses. Giemsa and Papanicolaou's stains were used. The cytological diagnosis was correlated with clinical and radiological data to arrive at a final diagnosis. RESULTS Reports on FNAC smears were retrospectively analysed, which had been done in various anatomic sites-liver (70 cases), colon (19 cases), gallbladder (17 cases), mesenteric lymph nodes (12 cases), ovary (3 cases), adrenals (2 cases) and 1 case each of pancreas, peritoneal wall, pelvic, suprapubic and flank masses. The mean age was 42.16 years with M:F of 1.3:1. The diagnostic yield was 85.2% in combination for Ultrasound Guided (USG) and Computed Tomography (CT) guided aspiration. The smears were classified as benign neoplastic, malignant neoplastic, non-neoplastic, inconclusive and unsatisfactory for interpretation. There were 79 (61.7%) malignant neoplastic lesion, 5 (3.9%) benign neoplastic lesion, 25 (19.5%) non-neoplastic lesion, one (0.7%) inconclusive lesions and 18 (14.1%) unsatisfactory smears. The liver and the colon were the most common sites. Adenocarcinomas and Hepatocellular Carcinoma (HCC) were the most common malignant lesions comprising of 35 (44.3%) and 25 (31.6%) of the total malignant lesions diagnosed. CONCLUSION Intra-abdominal FNA is a simple, economical and a safe procedure with high sensitivity, specificity and diagnostic accuracy and it can be utilised as a preoperative procedure for the management of intra-abdominal lesions.