Fine needle aspiration cytology plays an important role in avoiding unnecessary surgeries as benign and malignant lesions virtually cannot be accurately diagnosed by any non-invasive method. FNA has become the first line diagnostic test in the preoperative evaluation of thyroid lesions because of the simplicity, diagnostic accuracy and cost effectiveness. The Bethesda system of thyroid cytology reporting makes the reports clinically relevant and helps the clinicians to take appropriate therapeutic interventions. The study was conducted both retrospectively and prospectively over a period of 2 year. All fine needle aspirates of thyroid done in the Cytology laboratory of Department of Pathology of GMC Kathua were included in the study. A total of 76 patients were included in this study, Out of 76 patients, 69 cases were reported as benign (90.7%) lesions. Only 03 (3.9%) cases were reported as malignant lesions. 04 cases were reported as unsatisfactory aspirate due to scant cellularity. Among the benign cases, the most common diagnosis was benign follicular nodule in 50 cases (65.8%) followed by autoimmune thyroiditis in 17 cases (22.6%). 01 case (1.31%) each was reported as granulomatous thyroiditis and thyroglossal cyst. Benign follicular nodule cases comprised of 47 (61.8%) colloid nodule and 03 cases (3.9%) of adenomatous nodule. Among cases of autoimmune thyroiditis, 10 cases (13.1%) were reported as Hashimoto's thyroiditis and 7 cases (9.2%) were reported as lymphocytic thyroiditis. All the malignant cases were of papillary carcinoma, thyroid. Thyroid cytopathology can fairly distinguished between inflammatory, benign & malignant lesions. Therefore, thyroid fine needle aspirate is a cost effective, easy and time saving OPD procedure. It can reliably and effectively be used for preoperative diagnosis and accurate categorization of thyroid lesions.