Swellings in the Head and Neck region are very common and are evaluated with the help of a detailed clinical history, physical examination and investigations like FNAC, USG, CT scan or excisional biopsy. Fine Needle Aspiration Cytology (FNAC) is a simple, quick, inexpensive and minimally invasive OPD procedure used in the diagnosis of different swellings of Lymph nodes, thyroid, salivary gland and soft tissues in the Head and Neck region.We did this study with the purpose of identifying the frequency and distribution of different pathologies found in FNAC done in patients presenting with a swelling in the Head and Neck region as per the site, age, sex and type of the lesion.A retrospective study was conducted on the patients presenting with swelling in the Head and Neck region at the Pathology department of a tertiary care hospital between the duration of 1 August 2019 to 30 April 2021. FNAC was performed on total 260 patients.Out of 260 cases, 157 cases (60.4%) were from Lymph nodes, 50 cases (19.2%) from thyroid gland, 27 cases (10.3%) from skin and subcutaneous tissue, 23 cases (8.84%) from salivary gland and 3 cases (1.1%) were inconclusive due to inadequate material aspiration. 149 cases (57.98%) were inflammatory, 70 cases (27.24%) benign and 38 cases (14.78%) were found to be malignant.FNAC is a simple, quick, inexpensive, minimally invasive OPD procedure and used as first line of investigation in the diagnosis of swellings in the Head and Neck region.