Introduction: Lymph nodes are an important part of immune system. Their enlargement is noted in a wide spectrum of diseases, including infections and malignancy. Peripheral lymphadenopathy is common in all age groups and management of cases depends on lymph node pathology, which can be studied by collecting material through fine-needle aspiration or excision biopsy. 

Objectives: The study was undertaken to assess the cytomorphological features and incidence of various lymph node diseases on fine-needle aspiration cytology (FNAC) and to analyze the utility and diagnostic importance of FNAC in lymph node diseases. 

Materials and Methods: In the study total of 150 patients were selected who had presented with lymph node enlargement at Department of Pathology, KVG Medical College. 

Results: Reactive lymphoid lesions comprised the majority (33.69%) followed by tubercular lymphadenitis, metastatic malignancies, acute suppurative lymphadenitis, and lymphomas, respectively. 

Conclusion: Granulomatous lymphadenitis were the most common among the lymph node swellings presentations. FNAC is a simple, safe, reliable, and inexpensive method in early detection of lymph node lesions, which has been proven once again in this study.