Fine needle aspiration cytology (FNAC) is simple, quick, inexpensive and minimally invasive technique used to diagnose different types of swellings located in the head and neck region most commonly originating from cervical lymph node, thyroid, parotid and salivary glands. Aims: To assess the frequency of incidences of different sites, age groups, sex and distribution among inflammatory non neoplastic and neoplastic lesion. Material and Methods: A retrospective study was conducted between Jun 2011 to Jun 2012. Fine needle aspiration diagnosis was correlated with detail of relevant clinical data and investigations. Patients between the ages of 1 to 70 years were included in the study. A total of 450 patients with head and neck mass underwent FNAC. Results: Out of 450 fine needle aspiration procedures, 69% were of lymph node, 20% were thyroid, 06% from salivary gland, 06% from soft tissue and miscellaneous swellings. Conclusions: It is concluded that head and neck swellings are very common conditions in clinical practice. Our study found that FNAC is simple, quick, low cost and minimally invasive technique to diagnose different types of head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgical intervention.