Abstract This method must be accurate, easy to perform and acceptable to the patient. FNAC is an important diagnostic tool in management of patient with a breast lump. Considering patient's comfort, lack of requirement of anesthesia, it provides rapid and accurate diagnosis. This study was conducted to compare the diagnostic accuracy of fine needle aspiration cytology (FNAC) in differentiating the benign and malignant lesions of palpable breast lump with histopathological correlation and also to study the accuracy of FNAC procedure. Method: This study was a prospective study done in 50 patients presenting with palpable lump in the breast for FNAC to the Department of Pathology, VIMS. FNAC was performed with 23G needle. The material aspirated by FNAC and histopathology sections both were stained with H&E. Cytological diagnosis was compared with histopathology . Specificity, sensitivity, accuracy, and predictive values were calculated using standard formulas. Results: The diagnostic accuracy of fine needle was 88.6% and the overall sensitivity of fine needle aspiration cytology in diagnosing the palpable breast lump in our study was 85.71%, specificity was 100%, positive predictive of 100% and negative predictive value of 93.55%. Conclusion: A high positive predictive value and a high sensitivity indicate that a positive report of fine needle aspiration cytology confirms the final diagnosis of the disease when correlated with the histologic report.