Background: The incidence of clinically evident thyroid nodules is 4-5% in the general population. Fine needle aspiration cytology of thyroid can be used as diagnostic test along with ultrasonography for evaluation of thyroid lesions. Aims and Objective: To study cytological profile of thyroid lesions and correlate the results with Ultrasonography findings and clinical features. Material and Methods: This prospective study was carried out in department of pathology on 250 patients with thyroid swelling who came from surgical departments from the period of October 2016 to October 2017 at Narayana medical college and hospital, Nellore. Results of FNAC were correlated with those of USG reports and clinical features of the patient. Results: Out of 250 cases, 227 [90.8%] cases were benign, 8 [3.2%] cases were malignant on FNAC. About 220 cases (88%) were females and (12%) were males (male to female ratio 1:733). On USG 68% cases were diagnosed as benign and 2.8% cases were malignant. Out of which on cytology 90.8% were benign & 3.2% cases were malignant. On FNAC Multinodulargoitre (47.2%), colloidgoitre(6%), Thyroiditis((34%), diagnosed. Follicular neoplasm (4%), suspicious of malignancy 5 cases (2%) diagnosed under indeterminate category on FNAC. On USG nodular goitre (52.4%), colloid goitre(5.6%), Thyroiditis 73 cases(29.2%), Follicular adenoma 16 cases (6.4%) and malignancy 7 cases (2.8%). Thyroglossal cyst (2.8%), Graves disease (0.68%) diagnosed on FNAC and USG as well. Conclusion: Ultra sound and Fine needle aspiration cytology are advocated as first line examination for the assessment of thyroid lesions along with clinical examination and helps to come to the proper diagnosis

Keywords: Fine Needle Aspiration Cytology; Ultrasonography; Thyroid Lesions; Benign; Malignant.