Background: Lesions of liver, gall bladder and pancreas are quite common. After radiological assessment, FNAC under imaging guidance is an important tool in achieving early and accurate diagnosis, which is important in management of hepatobiliary and pancreatic lesions. The purpose of the study was to know the pathological spectrum of hepatobiliary and pancreatic mass lesions and usefulness of USG guided FNAC in diagnosis. Methods: A retrospective study was conducted in the Department of Pathology at Geetanjali Medical College and Hospital,Udaipur. A total of 173 FNA specimens from 171 cases over a period of three years from 1st January 2018 to 31st December 2020, with hepatic, biliary or pancreatic lesions were included in the study. Cytomorphological features were studied in detail and FNA specimens were categorized into categories including malignant, inflammatory, benign, suspicious for malignancy and inadequate. Results: FNA cytology was studied from 171 patients, aged 11 to 91 years, with mean age 54.5yrs. Out of 173 FNA specimens, most common were from liver (115,66.5%), followed by gall bladder (37,21.4%), pancreas (19,11.0%) and common bile duct (2,1.2%). Malignant lesions were the commonest (135, 78.0%). In liver metastatic tumors (64, 55.6%) were most frequent diagnoses followed by hepatocellular carcinoma (13, 11.3%). In biliary tract and pancreas, adenocarcinoma was the most commonly diagnosed lesion. Conclusion: FNA cytology is a useful tool in diagnosis of hepatobiliary and pancreatic mass lesions. It is safe, cost effective and rapid method which can be used after radiological investigation, especially in cases where biopsy cannot be performed
