Background: Salivary gland lesions encompass various non-neoplastic and neoplastic conditions with overlapping clinical presentations, posing diagnostic challenges. Fine Needle Aspiration Cytology (FNAC) serves as a minimally invasive, cost-effective technique for the preliminary assessment of such lesions. Still, its accuracy must be validated against histopathological examination, the gold standard for definitive diagnosis. Objective: This study aimed to evaluate the cytomorphological patterns of salivary gland lesions diagnosed through FNAC and to correlate these findings with corresponding histopathological results. Methods: A retrospective cross-sectional study was conducted at the Department of Histopathology and Cytopathology, Armed Forces Institute of Pathology, Dhaka Cantonment, from January 2014 to September 2015. A total of 55 cases with both FNAC and histopathological reports were analyzed. Data were statistically evaluated using SPSS version 11.0. Results: Among the 55 cases, submandibular gland lesions were most common (45.45%), followed by parotid (38.18%) and minor salivary glands (16.36%). FNAC identified 23 non-neoplastic (41.82%) and 32 neoplastic lesions (58.18%), including 19 benign and 13 malignant tumors. Histopathology confirmed 22 non-neoplastic and 33 neoplastic cases. Pleomorphic adenoma was the most frequent benign tumor, and mucoepidermoid carcinoma was the most common malignancy. Concordance between FNAC and histology was observed in 72.7% (40/55) of cases. FNAC demonstrated 92.9% sensitivity, 97.6% specificity, and high overall diagnostic accuracy. Conclusion: FNAC is a valuable first-line diagnostic tool in evaluating salivary gland lesions, with high sensitivity and specificity. However, certain limitations—particularly in distinguishing low-grade malignancies and some benign lesions—underscore the importance of histopathological confirmation in inconclusive or suspicious cases.