BACKGROUND AND OBJECTIVE: Cervical lymphadenopathy is the most common site of peripheral lymphadenopathy and is frequently encountered in otorhinolaryngology practice. Assessment and predicting its clinical behavior is not an easy task. Fine needle aspiration cytology (FNAC) is being routinely adopted as a special technique to diagnose the cause of lymphadenopathy. This study was undertaken to identify the clinic-demographic parameters in distribution of cases of cervical lymphadenopathy. FNAC was evaluated as a diagnostic tool by corroborating its results with histopathological examination of the excised lymph nodes. MATERIAL AND METHODS: This study was carried out at Hi-Tech Medical College and Hospital, Bhubaneswar, on 100 patients of cervical lymphadenopathy, over a period of two years. Along with detailed history, meticulous clinical examinations and investigations were performed. In all cases the diagnosis provided by FNAC and histopathology examination of the excised lymph node were correlated. RESULTS: Tuberculosis (45%) was the most common cause of cervical lymphadenopathy, followed by reactive (26%) and metastatic secondaries (21%) and lymphoma (8%). Maximum presentation was in 3 rd decade (22%) and bilateral involvement was seen in 20% cases. Posterior triangle was the most common site involved (45%). Overall diagnostic accuracy of FNAC was 92%. CONCLUSION: Most common cause of cervical lymphadenopathy are tuberculosis, reactive lymphadenitis and metastatic secondaries. FNAC is a cheap, quick, readily available and dependable diagnostic modality and can be used as a first line investigatory tool in outdoor departments.