Nodular enlargementis frequent and constitutes the commonestindication for thyroidectomy The vast majority of adult thyroid nodules are non-neoplastic lesions or benign neoplasm and fewer than 5% are malignant. Current guidance recommends the use of fine needle aspiration cytology  (FNAC)  as an essential  investigation in  patients  presenting  with a thyroid lump. However, only very few studies have looked specifically at the sensitivity  of FNAC in solely thyroid cancer patients. The aim of our study was to investigate the value of FNAC as a basic investigation in patients with thyroid enlargement. We aimed specifically to assess the sensitivity of FNAC  within cancer suspicious  group.  This had been done by reviewing  all cases  from January1st, 2001 to December 31st, 2012ftincludes all patients with simplenodulargoiter who underwent thyroid surgery during that period. Exclusion criteria: Patients who had recurrent goiter or secondary metastatic lesions. Total617 patients were included in the study Female to male ratio was 589 {90.6%) and 28(9.4%) respectively  Age of the patients ranged  from 15-72 years with mean age 38.5 years. Among  the 617 patients, preoperative fine needle aspiration cytology had been done to 409 cases only  Statistical analysis showed that preoperative FNAC sensitivity, specificity and accuracy are 68.27%, 87.40% and 85.89% respectively. We need to understand what a specific FNAC result means to patients management. Significant result of FNAC can provide preoperative guidance when assessing the probability of the target disorder. We had expected that a "malignant"  or "suggestive" FNAC result significantly enhances the probability of thyroid neoplasm and should be an absolute indication  for surgery