Lymphadenopathy is one of the commonest and significant manifestations of local as well as systemicailments, especially malignancies. Fine needle aspiration cytology (FNAC) helps in diagnosing the disease itself,in general, but more importantly ruling out malignancy, in particular. Hence it saves much of the cost and use ofresources incurred with excision biopsy of such lymph nodes. This prompted us to study the cytologic patternsof lymphadenopathy in our setting and the diagnostic utility of FNAC in the evaluation of lymphadenopathy. Inthis retrospective observational study, 1,579 patients (953 males and 626 females) with lymphadenopathy whowere subjected to FNAC over a period of three years (January 2009 to December 2011) were studied. The cervicalregion was involved in most of the cases (76%) followed by the axillary region (17.5%). Metastatic malignancy(38.2%) was the commonest cause of lymphadenopathy followed by reactive lymphoid hyperplasia (36.9%),tuberculosis (9.1%) and lymphomas (8.6%). Squamous cell carcinoma (32.2%) followed by adenocarcinoma(21.9%) were the most frequent metastatic tumors. FNAC is a useful diagnostic tool in the management ofpatients presenting with lymphadenopathy and should be considered before more invasive and costly proceduresare performed, particularly in developing countries.