Abstract Background: Lymphadenopathy is a common clinical presentation in outpatient clinics. Fine needle aspiration cytology (FNAC) of the enlarged lymph node is an easy and simple tool for clinical management. This is because it is fast and minimally invasive with minimal complications. Aim of Study: To evaluate the reliability and validity of conventional FNAC of cervical lymphadenopathy. Patients and Methods: This prospective study was carried out on 50 patients with cervical lymphadenopathy. The cy-topathological diagnoses obtained by FNAC were compared with the histopathological results of the ongoing excised nodes. Results: Fifty four percent of our cases were females. Seventy four percent of our cases were less than 40 years. The cytological diagnoses were benign in 29 cases (58%) and malignant (diagnostic or suspicious for malignancy) in 21 cases (42%). The sensitivity, specificity, positive predictive value, and negative predictive value were 84%, 100%, 100%, and 86.2%, respectively. The overall diagnostic accuracy was 92% (46/50), while the overall discordance rate was 8% (4/50). Conclusions: FNAC is a reliable method for diagnosis of tuberculous lymphadenitis. It shows a high specificity for malignant cervical lymphadenopathy and provides the physi-cian with valuable information for patient management. The sensitivity of FNAC in detection of malignancy is relatively low in cases of lymphoid neoplasm owing to missing Hodgkin's cells in the aspiration of Hodgkin's lymphoma and to difficulty in cytodiagnosis of low-grade lymphoma without use of flow cytometry.