Background: Lymphadenopathy is a common presentation in both benign and malignant diseases which needto be diagnosed without delay. Fine needle aspiration cytology (FNAC) helps us diagnose a disease and followits course, including the response to therapy. Aim: This study aimed to analyze the clinicopathological featuresof metastatic lymphadenopathy and the diagnostic utility of FNAC in our setting. Materials and Methods: Thistwo-year prospective study included all the patients with metastatic lymphadenopathy, diagnosed with FNAC. Results: A total of 412 cases (male:female ratio, 1.3:1; age range, 3 to 90 years) were studied. Supraclavicularlymph nodes were involved most commonly (50.5%). The commonest metastatic tumor was squamous cellcarcinoma in general (30.1%) and in males (37.6%), and infiltrating ductal carcinoma (25.3%) in females. Lung,with 64 (15.5%) cases followed by esophagus, 60 (14.6%) cases; breast, 49 (11.9%) cases; skin, 32 (7.8%) cases;and stomach, 25 (6.1%) cases were the most common primary sites of malignancy. In 69 patients, excision biopsywas performed. Histopathological findings correlated well with that of cytology in all these cases. Conclusions:FNAC is an important tool in the diagnostic work up of metastatic lymphadenopathy, which in the hands of anexperienced and skilful cytopathologist can avoid the need for excision biopsy.