Background: Pediatric lymphadenopathy is a challenging medical situation for the child patient, the parents, and the physician. Although the bulk of masses will be benign the fear of malignancy is omnipresent. Therefore, the objective of this study was to identify the common cytopathological patterns of lymphadenopathy among Sudanese children. Methods: One hundred pediatric patients presenting with peripheral lymphadenopathy were included in the study, their ages ranging from 2 to 14 years, with a mean age of 7 years. Demographic characteristics, clinical manifestations and FNA materials were prospectively obtained. Results: FNA was performed in 100 cases (100%). There were no technical complications. All cases confirmed adequacy of specimen. Overall, FNA demonstrated 90 (90%) benign lesions and 10 (10%) malignant diagnosis. The benign lesions were reactive lymphoid hyperplasia (n=64), followed by benign granulomatous disease (n=26). Of the 10 cases diagnosed with malignancy, 7 (7%) were cases of non-Hodgkin`s lymphoma and the remaining 3 (3%) were Hodgkin's lymphomas. Conclusion: Pediatric lymphadenopathy is common in Sudan. CLA is the common frequent site. Lymphoma represents a major challenge in this setting.