Lymph node enlargement in the pediatric age group is multifactorial in aetiology and careful assessment of patients combining the clinico-demographic, radiological as well as pathological findings can bring light on various local and systemic diseases which can have trivial effects to even life-threatening consequences for the patients. An easy, rapid and fairly accurate method of Fine needle aspiration cytology (FNAC) is very valuable in giving preliminary diagnosis and guiding further

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... t plan for the patient. Objective: To assess the diagnostic role and efficacy of FNAC in the pediatric Lymphadenopathy (LAP) cases. Methods: Data form 235 cytology reports from patients </=18 years of age who presented with LAP over a period of 2 years from August 2018 to August 2020 are retrospectively collected, compiled and analyzed in the Results: Majority of the patients are in the age group of 11-15 years, with a male: female ratio of 1.29:1. FNAC results were benign for 97.3% of cases, which included mostly Reactive hyperplasia (58.74%), followed by granulomatous/necrotizing lymphadenitis (LAN) (23.31%), Suppurative LAN (14.35%) and Rosai Dorfman disease (0.90%). Malignancy was identified in 6 cases (2.7%) which included 4 cases of Hodgkin's Lymphoma (1.80%), and 2 cases of metastatic malignancy (0.90%). Histopathological correlation was done in 10 cases, which showed accuracy, sensitivity and specificity of 90%, 100% and 80% respectively. Conclusion: With an adequate correlation of clinical-radiological and other laboratory findings, FNAC is a very reliable screening and diagnostic tool in the cases of Pediatric LAN.