Background: Discrete thyroid swelling is common clinical presentation with prevalence rate of 4-7% in the general population. Now fine needle aspirate cytology (FNAC) is very important technique fordiagnosis of thyroid nodules, as it is very simple, safe, less invasive technique.Objective:To evaluate the diagnostic accuracy ofFNAC inThyroid Nodules.Patients and Methods:Study carried out on patients who visited the Outpatient Clinic of General Surgery Department, Qena University Hospital complaining of thyroid nodules,in the period from April 2017 to July 2018Results:Out of the 100 patients 76 were females and 24 males. The age ranged from 11-60 years.FNAC showed overall diagnostic accuracy of 97.01% with specificity of 98.39 %, sensitivity of 80.00% for malignant lesions, positive predictive value of 80.00% for malignancy and negative predictive value of 98.39%.Conclusion:FNAC is an invaluable and minimally invasive procedure for pre-operative assessment of patients with a thyroid nodule. FNAC has high sensitivity in picking up malignancy.Keywords:Fine Needle Aspiration Cytology(FNAC), BETHEDA System, Thyroid, Histopathology