Background: Touch imprint cytology (TIC) is a method used with remarkable success in the diagnosis of tumors. Objectives: To assess the utility (sensitivity, specificity and accuracy) of an intraoperative touch imprint (TIC) in the diagnosis of the ear, nose and throat and head and neck mass lesions, we compared TIC with permanent hematoxylin and eosin histology in the diagnosis of these lesions. Materials and methods: We evaluated thirty ear, nose and throat and head and neck mass lesions by TIC. The results of TIC preparations were intraoperatively correlated with gross picture and subsequently with permanent histologic sections of representative biopsies. The study period ran between January, 2003, and January, 2004. Eight touch imprints and histology sections were prepared from every case and were reviewed by two pathologists independently. Further immunohistochemical evaluation was performed on the tissue sections. Results: Examination of TIC identified 12, 16 and 2 specimens as benign, malignant and suspicious of malignancy respectively. Permanent histological sections revealed 15 benign and malignant cases (each). There was one false-positive case. Sensitivity and specificity of touch preparation cytology were 88% and 92%, respectively. Conclusions: TIC can rapidly and reliably evaluates ear, nose and throat and head and neck mass lesions and therefore overcome sampling errors and artifacts that may be related to frozen section evaluation.