BackgroundrnThyroid diseases are among the most common endocrine disorders worldwidernincluding in Ethiopia and Patients with thyroid diseases can present with diffuse orrnnodular thyroid enlargement. Determining the type of the lesions in a given setup hasrnparamount importance to design effective therapeutic strategy. As a result, thernaim of this study was to find out the cytological patterns of thyroid lesions andrncompare these cytopathologic reports with their corresponding histopathologicrndiagnosis at Black Lion Hospital.rnMethodsrnThis was a retrospective cross sectional descriptive study conducted on 687 patientsrnhaving cytopathologic evaluation for thyroid lesions at Black Lion Hospital betweenrnJanuary 2015 and August 2019.rnResultsrnMost of the patients were in the age range of 20-60 years, accounting forrn521/663(77.3%) cases with Mean age of 41.98 and F:M ratio of 4.69:1. Non-rndiagnostic(Inconclusive), Benign (Non-neoplastic lesions), Follicular neoplasm,rnHurthle Cell neoplasm, Suspicious for malignancy and malignant cytopathologicrndiagnosis accounted for 33(4.8%),504(73.4%),51(7.4%),11(1.6%),3(0.4%) andrn85(12.4%) of the cases respectively. Among the Benign (Non-neoplastic lesions),rnColloid Goitre was the most common diagnosis occurring in 458(90.9%) of the cases.rnThe minimum and maximum age for the occurrence of malignancy in the study wasrn21 and 80 years old respectively and Papillary Carcinoma was the leading type ofrnmalignancy accounting 43(48.9%) of all malignant cases followed byrnAnaplastic(Undifferentiated) Carcinoma constituted 20(23.6%) of the malignantrnvirncases.rnFrom all 687 patients with cytopathologic evaluation, only for 19 of them werernhistopathologic reports available for comparison. Eleven of the 19 cases wererndiagnosed benign(non-neoplastic) lesions by FNAC and 2 ended up with malignantrndiagnosis histologically. Six of the 19 cases had malignant diagnosis by FNAC and 2rnbecame adenoma up on histologic examination.rnConclusionrnFNAC is an important tool for the management of thyroid lesions. It is simple,rncost-effective technique without any major complications and with minimalrndiscomfort to the patient.