This study evaluated the effectiveness of fine needle aspiration of thyroid nodules to reliably diagnose thyroid malignancy, using histopathology as the 'gold standard'. Out of 126 patients, 106 underwent surgery. The sensitivity, specificity and positive predictive value of fine needle aspiraton cytology to diagnose a papillary carcinoma in this study were 80.7%, 96.5% and 87.0% respectively. The accuracy of fine needle aspiraton cytylogy was 80.9%. Six cases that were benign by fine needle aspiraton cytology were confirmed to have malignant lesion by histopathological examination. High resolution ultrasonography could be useful in these situations for considering surgery.