Introduction: The Bethesda system is a uniform reporting system for thyroid cytology that facilitates the clarity of communication among pathologists, and surgeons and facilitates cytohistologic correlation for thyroid diseases. An implied risk of malignancy, a preliminary triage, and at times a definitive diagnosis can be offered. Immunocy to chemistry can be done on cell blocks. Molecular studies can also be performed. Objective: This study was carried out to evaluate thyroid lesions by fine needle aspiration cytology (FNAC) based on Bethesda system of reporting. Materials and Methods: A total of 40 patients with clinically palpable thyroid lesions were studied at our institute between July 31, 2020, and December 31, 2020. FNAC was performed on those patients and slides were made, both air dried (MGG stained) and wet fixated (PAP, H & E stained). The slides were screen under light microscope and results were compared. Results: Based on the Bethesda system of classification of thyroid lesions, out of total 40 samples: 02 samples were diagnosed as non-diagnostic even after re-aspiration (Category 1). 21 lesions were diagnosed as benign (Category 2). 07 were in category of follicular lesion of undetermined significance (Category 3). 05 were diagnosed as suspicious for follicular neoplasm (Category 4). 03 as suspicious for malignancy (Category 5). 02 cases as malignant (Category 6). Conclusions: Reviewing the thyroid FNAs with the Bethesda system for reporting allowed precise cytological diagnosis. Nature of the disease, experience of pathologist, and understanding of certain limitations determine its diagnostic utility. Discussion: FNAC is a widely accepted method used in the diagnosis of patients with thyroid nodules. The lack of consistency in reporting FNA was solved in 2007, when TBSRTC was introduced.