This study aimed to evaluate the diagnostic utility of Fine Needle Aspiration Cytology (FNAC) in the evaluation of neoplastic cutaneous nodular skin lesions and to provide insights from a tertiary care institute. A total of 150 patients with cutaneous nodular skin lesions were included in the study, and FNAC was performed using a 23-gauge needle attached to a 10-ml syringe. The study found that FNAC is a valuable diagnostic tool for the evaluation of neoplastic cutaneous nodular skin lesions. It had a sensitivity of 88% and a specificity of 100% for diagnosing malignant lesions. The high sensitivity and specificity of FNAC for diagnosing malignant lesions indicate its usefulness as a diagnostic tool, and it can also help to guide appropriate management and treatment decisions. Therefore, FNAC should be considered as an initial diagnostic tool for evaluating cutaneous nodular skin lesions.