Tuberous xanthomas are large nodular lesions that develop in patients with underlying hyperlipoproteinemias. A patient was referred to us for fine needle aspiration cytology (FNAC) from multiple lesions over extensor aspect of upper and lower limbs, which yielded scanty aspirate despite several attempts. This case is being reported to emphasize how such lesions can present as diagnostic challenge on cytology, the role of which has not clearly been described in the previous case reports.