Introduction: In surgical practice, thyroid lesions are common, observed in 4-7% of the population and affect women more commonly than men. Excising all the thyroid lesions is impracticable and associated with risk [1, 2].Therefore an effective screening test is needed to avoid unwanted surgery. The routine use of FNAC in the assessment of thyroid lesions has reduced the number of patients subjected to thyroidectomy for benign lesions. Aims and Objectives: Present study was undertaken evaluate the efficiency of FNAC in the diagnosis of clinically obvious and palpable thyroid lesions. Materials and methods: This study has both retrospective and prospective cases conducted in the department of pathology M.R Medical College Gulbarga. Cases from Basaveshwar teaching and general hospital, Govt. General Hospital, peripheral cancer centre, Gulbarga and various private laboratories, in Gulbarga were included in the study. Results: This study included 220 cases. From the 218 satisfactory cases of FNAC’s of thyroid lesions maximum cases were benign lesions 201 (91.37%) malignant cases were 17 (7.73%) and 2 cases were unsatisfactory (0.9%) , with diagnostic accuracy of 97.56% sensitivity 90% and specificity 100%. Conclusion: Results of present study as well as previous various studies highlight the utility of FNAC in thyroid lesions as safe, cost effective and initial diagnostic modality avoids unwanted surgeries.