BACKGROUNDLung cancer is the major cause of cancer related deaths all over the world. Computed Tomography (CT) -Guided Fine Needle Aspiration Cytology (FNAC) of a lung mass is an effective modality to diagnose lung cancer. FNAC is a rapidly emerging diagnostic modality to assess the nature of radiologically demonstrated lung mass lesions. We wanted to study the usefulness of CT-Guided FNAC in the evaluation of cytopathological spectrum in lung lesions. METHODSA cross-sectional study was carried out in a total of 150 cases for a period of 5 years from November 2014 to November 2019 on cases of lung mass lesions with a strong clinical suspicion of pulmonary neoplasm. CT-Guided transthoracic FNAC was performed and cytology smears were stained with May-Grunwald-Giemsa (MGG) stain, conventional Papanicolaou (Pap) stain and Ziehl Neelsen (ZN) stain. Smears were examined under microscope and broadly categorized into unsatisfactory, tubercular, benign and malignant lesions. RESULTSA total of 150 cases of lung mass lesions were studied, of which 85 were males (78.4%). The mean age of the patients was 67 years. Maximum cases of benign lesions were chronic non-specific suppurative lesions (17.3%, 26 cases) followed by tuberculosis (3.3%, 05 cases). Regarding the malignant categories, adenocarcinoma (22.7%; 34 cases) was the most common malignancy followed by non-small cell carcinoma not otherwise specified (NOS) (14.7%; 22 cases), squamous cell carcinoma (8.0%, 12 cases) and small cell carcinoma (6.7%; 10 cases) respectively. CONCLUSIONSCT guided FNAC is a simple, less expensive, and reliable method for diagnosis of pulmonary lesions.