Background: CT-guided fine-needle aspiration cytology is an established, indeed effective and precise method for diagnosing of pulmonary lesions. Though this procedure has the possibility to lead lung complications. Therefore, this study aimed to learn about the pathological spectrum of pulmonary lesions, examine the pattern of FNAC diagnosis of lung lesions, and analyse and compare the data with published figures. Material & method: This study was carried out at the Pathology Department of Tairunnessa Memorial Medical College and Hospital, as well as the Popular Diagnostic Center in Gazipur, Bangladesh, where all cases were FNAC and cytologically diagnosed. From September 2000 to April 2022, a total of 171 cases were evaluated. All of the patients had nodular or mass lesions in their lungs and were diagnosed with a CT-guided FNAC by following a standard procedure. Result: Out of 171 cases about 119 (69.59%) were male and 52 (30.40 %) female. It was noticed that approximately 117 (68.42%) were malignant cases. Of these, most common malignancy was adenocarcinoma (43.27%). There were about 31.67 % benign lung lesions cases. Among them, 17.54%, 8.87%, 3.5%, and 1.67% cases had pulmonary inflammatory lesions, tuberculosis, aspergillosis and abscess, respectively. Conclusion: CT guided FNAC can diagnose pulmonary lesion fairly and accurately as well as may leading to less morbidity & mortality as treatment can be started early.