Background: Thyroid diseases are among the commonly encountered disordered in any hospital. Majority of thyroid lesions are non-neoplastic and 5%-10% are malignant. Fine needle aspiration cytology (FNAC) is now a well-established, first line, simple and quick screening test as well as the diagnostic tool for surgical and non-surgical goitres. It is a very useful modality to decide on the patients requiring surgery from those who need not be operated. Objective: To identify the cytomorphological spectrum of thyroid lesions and correlate with the clinical findings at the tertiary care centre. Material and Methods: A total of 90 cases undergoing FNAC were enrolled. Thyroid swellings were aspirated using 23 gauge disposable needles fitted with 10 ml disposable syringes. The aspirated material was smeared into glass slides with preparation of both air dry smears for May-Grunewald Giemsa stain and 95% alcohol fixed smears for Haematoxylin and Eosin stain. Cytological evaluation was performed and cytological results were correlated with clinical features, thyroid function tests and histopathological examination. Results: The most common age groups affected were 21 to 30 years (28.89%). Female outnumbered the males with female- male ratio of 6.5:1. Out of 90 cases benign lesions were observed in 80 cases (88.89%) followed by malignant 6 cases (6.67%) than atypia of unknown significant was present in 4 cases (4.44%). Out of 80 benign lesion cases, Benign Follicular Nodule Lesion were most common 62.23% while out of 6 malignant lesions, Papilary Carcinoma was most common found in 4 cases Conclusion: Fine needle aspiration cytology is a cost effective procedure that provides specific diagnosis rapidly with minimum complications. It helps to differentiate cysts from solid tumors and serves as a therapeutic procedure when a cyst is encountered.