Fine-needle aspiration of thyroid standard of care worldwide and is routinely deployed for the management of thyroid nodules. Its indications include the initial evaluation of the cause of diffuse thyroid swelling, subtyping a clinically detected thyroid malignancy and to follow up autoimmune thyroid disorders etc. Image-guided FNA is performed by close coordination between radiologist and cytopathologist. FNA procedure can also be performed by both nonaspiration and aspiration techniques. Ultrasound-guided FNAC of thyroid is useful, especially in cystic and multinodular lesions harboring malignancy. Ultrasound-guided FNAC and Reporting terminology of FNA findings are used for nondiagnostic or unsatisfactory specimens, benign follicular nodule, follicular neoplasm, malignant thyroid carcinomas etc. Adequacy assessment, diagnostic accuracy and limitations of FNA also thoroughly described. Ancillary tests also discussed here.