Introduction: Fine needle aspiration cytology (FNAC) of thyroid is a minimally invasive, cost-effective and an easy to perform outpatient procedure. FNAC along with thyroid function test (TFT) and ultrasonography (USG) helps in proper preoperative assessment, changes clinical management and improves patient outcome. Objectives: 1. To study the cytological features of thyroid lesions using FNAC using. The Bethesda System for Reporting Thyroid Cytology. 2. To correlate thyroid cytology with thyroid hormonal status and USG. Materials/Methods: The study was conducted in the Department of Pathology from January 2020 to December 2020 and included 50 patients with thyroid lesions who underwent FNAC, thyroid function tests and USG. Lesions were evaluated cytologically and categorized according to Bethesda System of classification and correlated with Thyroid profile and USG. Results: Out of 50 cases, females were most affected (92%). Most affected age group was middle aged (21-50 yrs). Bethesda Category I to VI cases were 4%, 82%, 2%, 4%, 2% and 6% respectively. Colloid goitre was the most common among non-neoplastic lesions. Majority of the benign and all malignant lesions were euthyroid. Hypothyroidism was mostly seen in Hashimoto thyroiditis. In 92% of the cases, USG and FNAC diagnosis correlated well. Conclusion: FNAC is a simple diagnostic modality for thyroid lesions with high specificity. The study showed that cytological analysis in conjunction with thyroid profile and USG helps to make accurate diagnosis and determine the course of therapy in effective management of patients with thyroid lesions.