Background: Surgical excision of all thyroid nodules would result in a large number of unnecessary procedures. Fine needle aspiration cytology is safe and minimally invasive OPD procedure for the pre-operative assessment of patients with a thyroid nodules . The purpose of our study was to assessment of diagnostic significance of FNAC and its applicability to detect which patients need follow-up and who need surgical intervention. Patients and methods: A prospective cross sectional study was conducted on 76 patients with thyroid lesions at Surgical oncology unit in department of General surgery, Zagazig university hospital who had FNAC, underwent surgery and histopathological results was obtained from the period of December 2019-May 2020 were recruited in the study. Results: In this study, benign thyroid lesions were the commonest found in 58 patients (76.3%). Out of all benign lesions, simple colloid goiter (36.8%) was the most common. Thyroid lesions showed female preponderance, with 88.2 % females and 11.8 % males and a male: female ratio of 1:7.5. , The sensitivity, specificity, and diagnostic accuracy of FNAC were 83.33%, 100 %, and 76.5 %, respectively. Conclusion: Fine needle aspiration cytology (FNAC) is a simple and safe procedure and devoid of any serious complications. it is a sensitive, specific, and accurate initial diagnostic test for the preoperative evaluation of patients with thyroid swellings.