Objectives: This study was taken up with the aim to investigate the pattern of cervical lymphadenopathy and to evaluate diagnostic efficacy of FNAC among the patients of tertiary care hospital. Material and methods: This study was carried out at tertiary care hospital on 70 clinically diagnosed cases of cervical lymphadenopathy over a period of 1 year. FNAC was carried out in all these patients. Biopsy and special stains were done in selected cases. Results: Out of 70 cases, 41 were males and 29 were females. Among the diagnostic outcome, 34.28 % were having tuberculous lesions followed by 24.28 % of reactive hyperplasia, 21.43 % of secondary metastases, 11.43 % of lymphoma, 7.15 % of acute non specific lymphadenitis and 1.43 % of miscellaneous lesions which includes one case of Rosai Dorfman syndrome. Conclusion: The most frequent cause of cervical lymphadenopathy is tuberculosis followed by reactive lymphadenitis and metastatic malignancies. It played vital role in the management of cervical lymphadenopathy. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries.