Most diseases of the breast present as a palpable mass. The majority of breast lesions are not malignant, and most benign lesions do not progress to cancer; however the accuracy of diagnosis can be increased by a combination of preoperative tests like physical examination, mammography, fine-needle aspiration cytology (FNAC), and Tru cut needle biopsy (TGNB) or core needle biopsy (CNB). FNAC has grown in popularity and became the first initial used procedure after history taking and clinical examination for diagnosis of solid and cystic breast lumps. This study was designated to investigate the accuracy of FNAC in comparison to TCNB for diagnosis of palpable breast masses. Subjects and methods: Fine needle aspirates (FNA) were obtained from all patients and TGNB were obtained from 57 patients. Surgical biopsy specimen (SBS); incesional and/or excesional were done for 71 patients. The success rate, sensitivity and specificity of FNAC were calculated and the results were compared with those of TCNB. Results: The success rate, sensitivity and specificity of FNAC were 76.1%, 93.4% and 78.3% respectively. The success rate, sensitivity and specificity of TCNB in this study were 89.5%, 86.1% and 100% respectively. Conclusion: FNAC is a reliable tool for diagnosis of benign and malignant breast lesions with accuracy comparable to TCNB. The success rate decreases in cases of recurrent lumps. TCNB has the upper hand for full histopathological diagnosis of breast lesions