Introduction: As Fine needle aspiration cytology (FNAC) is the primary investigation for the management of thyroid lesions, its interpretation is very crucial.The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) for clarity of communication recommends that each case should be reported in 1 of 6 general diagnostic categories facilitating communication among the managing team of doctors and leaves almost no confusion regarding the management of thyroid lesions. Aim: To study utility of The Bethesda system of reporting thyroid cytopathology. Materials and Method: During period of 1 year from 1st January to 31st December 2012 aspiration cytology has been carried out in 160 thyroid swellings referred to cytology department of a tertiary care hospital in Surat. Fine needle aspiration cytology was performed using mainly non-aspiration and aspiration techniques. All the cases were reported using TBSRTC. Cases were followed whenever possible.