Background: The presence of a mass in head, neck and face region often pose a challenging diagnostic problem to the clinician who is confronted with a maze of possibilities. The routine work up comprises of clinical history, clinical examination and other diagnostic aids like radiology which often fail to resolve the vexing problem regarding the nature of the mass. An early recognition and categorization of lesions is essential for treatment. Aim of the Study: To assess the utility of FNAC as an initial diagnostic modality in patients with swellings in the head, neck and face region. Materials and Methods: The study was conducted in the Department of General Pathology of D.Y. Patil Medical College. The ethical clearance for study protocol was obtained from ethical committee of the institution. The present study emphasizes on the diagnostic utility of the fine needle aspiration of head, neck and face swellings. This study is undertaken from February 2015- June 2016. All the patients referred to the department of pathology for FNAC of swellings in the region of head, neck and face, were analysed. A total number of 484 FNAC cases are analysed in this study.