Cytological examination of body fluids enables us to examine and differentiate between inflammatory, benign and malignant effusions. Cell block (CB) technique is method of cytological examination of serous fluids besides conventional smear (CS) technique. The aim of this study was to compare the role of cell block technique over the conventional smear technique in the cytological diagnosis of serous fluids. This was a prospective study done at our medical college and tertiary care hospital between 2017 to 2020. A total of 114 patients were included in the study that underwent paracentesis for effusion cytology. Equal quantities of pleural and peritoneal fluid received and prepared into CS and CB for examination. Cellularity, architecture patterns, morphological features and yield for malignancy were compared, using the two methods. 71 were pleural fluid and 43 were peritoneal fluids. CS and CB comparison for cellularity showed statistically significant (p<0.05) and comparison of malignant effusion done with McNemar’s test for CB showed that CS method was not superior to CB method in pleural, peritoneal and total body effusions. The stastistical analysis of malignant effusions (n=114) for cell block method for sensitivity was 100%, specificity 79.63%, positive predictive value 21.43% and negative predictive value 100%. The CB method provides high cellularity, better architectural patterns, morphological features and an additional yield of malignant cells than CS method. CB method is superior to CS method.