Abstract Background and objectives : A palpable breast lump is defined as a dominant mass if it is 3-dimensional, distinct from surrounding tissues, and asymmetrical relative to the other breast. A method of definitive diagnosis of patients who present with palpable breast lump at the outpatient clinic is needed. 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 : In this study Fibroadenoma was most common benign lesion and Infiltrating ductal carcinoma is most common malignant lesion. Diagnostic accuracy of FNAC was 88.6% and overall sensitivity of FNAC in diagnosing the palpable breast lump was 85.71%, specificity was 100%, positive predictive of 100% and negative predictive value of 93.55% Conclusion: The diagnostic efficacy, sensitivity and specificity observed in this study by FNAC were comparable to Histopathological examination. Hence FNAC stands as an effective and valid tool as a first line diagnostic modality in the preoperative diagnosis of both benign and malignant lesions. A positive correlation was observed between Robinson cytological grading system and Scarff Bloom Richardson Histological grading system.