BACKGROUND Fine needle aspiration cytology (FNAC) is a simple, reliable, inexpensive, easily acceptable procedure and already has a well-established role in the diagnosis of palpable female breast lesions. However, breast lumps in males are rarely aspirated and hence there is limited cytopathologic experience. The present study aims to determine the role of FNAC in the diagnosis of male breast lesions and also to describe the various cytomorphologic features of these lesions. METHODS The present study is a retrospective analysis of all male breast lesions over a period of five and half years i.e., January 2013 to June 2018 in the Department of Pathology, JNIMS, Manipur. All available data on male breast FNAC done during this period was retrieved from the records of the cytopathology laboratory. The cytologic slides and reports were reviewed and various cytomorphologic features were reassessed. FNAC diagnoses were categorized as benign, malignant, atypical, suspicious and inadequate or unsatisfactory. RESULTS There was a total of 780 patients who underwent breast FNAC during the five-anda-half-year period out of which, 48 were male patients. The most common lesion was gynaecomastia which most commonly occurred in the age group of 51-60 years. Benign breast lesions were found to be more common than malignant breast lesions. Malignant lesions occurred a decade older than benign breast lesions. CONCLUSIONS FNAC is an accurate, safe and simple tool in the diagnosis of male breast lesions. In the hands of an experienced cytopathologist, it is highly sensitive and specific. Therefore, FNAC should be used confidently and be included as a standard first-line investigative procedure in the primary assessment of breast lumps in males as well.