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Background: Fine-needle aspiration cytology (FNAC) is a first-line investigation modality for the evaluation of cervical lymphadenopathy. Aim: This study was undertaken to assess the utility and diagnostic efficacy of FNAC in the evaluation of cervical lymphadenopathy. Materials and Methods: A total number of 497 lymph node FNACs were retrieved and evaluated retrospectively between March 2012 and August 2015. Of these, 188 cases had subsequent histopathological follow-up. Their FNAC diagnoses were compared and correlated. Results: Among 188 FNAC cases, 157 (83.5%) were benign, 14 (7.4%) were suspicion of malignancy, and 17 (9.1%) were malignant. On correlation of subsequent histopathology, 151 cases were confirmed as benign (true negative) and 28 cases were confirmed as malignant (true positive). There were three false positive and six false negative results. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive values of FNAC were 82.4%, 98.1%, 95.2%, 90.3%, and 96.2%, respectively. Conclusion: Our study concluded that FNAC in the diagnosis of cervical lymphadenopathy was sensitive, specific, and accurate. FNAC is a useful and reliable diagnostic tool that also appears to be a safe and minimally invasive procedure that provides preoperative information for the appropriate management.