Background: Cervical lymphadenopathy is a common clinical problem causing diagnostic dilemma. Various causes ranging from infections to autoimmune disorders are contributory. Hence it becomes essential to categorize them based on clinical and laboratory investigations to aid in diagnosis and management, of which FNAC remains a gold standard test. Aims and Objectives: To evaluate the accuracy of FNAC in determining the causes of cervical lymphadenopathy in children. Materials and Methods: A prospective study was conducted in children aged 1 -12 years with significant cervical lymphadenopathy for 2 years. Children were subjected to thorough clinical and investigatory assessment including complete hemogram, ESR, Mantoux, FNAC, chest X-ray and viral serology. Results: FNAC showed reactive hyperplasia due to underlying infections as the commonest etiology (74.66%) followed by granulomatous (13.33%), suppurative adenitis (6.66%) and others (5.35%). Conclusion: Conventional laboratory tests though have an ability in arriving diagnosis, FNAC is a simple, reliable and valuable diagnostic tool in the management of cervical lymphadenopathy in children. This reduces the need for costly procedures and provide timely utility in the treatment of lymphadenopathy.