In most centers only selected patients with high risk thyroid nodules undergo thyroid surgery, and fine needle aspiration biopsy (FNA) is used to select patients for surgical treatment. The aim of the present study was to evaluate the impact of FNA on the management of thyroid nodules at our institution. A total of 872 patients who underwent FNA over a period of 7 years were retrospectively analyzed. There were 66 men and 806 women with a mean age of 40 +/- 15 years. Altogether 549 patients presented with a thyroid nodule and 323 with multinodular disease. The sensitivity and specificity of FNA were 90.0% and 99.8%, respectively. The positive and negative predictive values were 98% and 99%, respectively, and the accuracy was 99%. Our results are in agreement with those of other reports establishing that FNA of the thyroid is safe, reliable, and effective for differentiating benign from malignant nodules.