Lymphadenopathy is the most common presentation in the head and neck region and may occur due to inflammatory conditions, as well as primary and secondary neoplasms. An early and accurate diagnosis helps the clinicians in starting the specific therapy on time, thus reducing morbidity and mortality. The present study was undertaken to know the spectrum of lesions found in the Enlarged cervical lymph nodes in 628 patients. Cervical group of lymph nodes are the most common lymph nodes involved in head and neck region. Non-specific reactive lymphadenitis is the most common benign pathology associated with enlarged lymph nodes whereas metastasis is the most common malignant condition. Most common age group of enlarged lymph nodes in benign category was 3rd decade and in malignant category was 6th decade. The sensitivity and specificity of FNAC is fare enough with lot of various other advantages like rapid diagnosis, reliable, less traumatic, minimal complication, repeatability, economical and convenient. Fine needle aspiration cytology in our experience provides a reliable method of investigating lymph node enlargement, the efficacy of which approaches that of other similar diagnostic procedures and in the present study, over all accuracy and sensitivity was 94.8% and100% respectively.