Background and Objective: Fine needle aspiration cytology (FNAC) is a well-established method of diagnosis in palpable masses of various sites. This study was conducted to evaluate the usefulness of FNAC as a diagnostic tool in the management of patients with cervical lymphadenopathy. Patients and Methods: Totally 178 patients admitted to Loghman-Hakim Hospital , Tehran, Iran, with cervical masses, were included in this study. They had undergone FNA and subsequently excisional biopsy of the same neck mass in which a lymphoid tissue lesion had been established. Results: Reactive lymphadenitis, metastatic neoplasm, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma constituted 59.6%, 17.9%, 14.6% and 7.8% of total cases, respectively. In 27 cases (15.2%), the FNA findings were nondiagnostic. Diagnostic accuracy of FNAC was about 88%. Sensitivity, specificity, positive and negative predictive values were 75.8%, 96.6%, 94% and 85.1%, respectively. Conclusion: FNAC has a high accuracy in the diagnosis of malignancies of cervical lymph nodes, but due to the existance of false negative cases, the benign results should be further evaluated if high clinical suspicion of malignancy exists.