Background: Thyroid nodules are disorders of the thyroid gland, consisting of colloid nodules, cysts, and thyroiditis found in 80% of cases, while benign follicular neoplasms and thyroid carcinomas occur in 10%-15% and 5% of cases. The most common thyroid carcinoma is Papillary Thyroid Carcinoma (PTC), with an incidence rate of about 80% of all thyroid carcinomas. Distinguishing preoperative benign lesions is very important to prevent unnecessary surgery, therefore Fine Needle Aspiration Biopsy (FNAB) is needed, and easy to perform, this examination is the first line in evaluating preoperative thyroid lesions. Objective: Assess the accuracy of FNAB examination compared to histopathological examination in diagnosing PTC. Methods: This study is a diagnostic test. The population of this consisted of secondary data, patients with thyroid nodules diagnosed with PTC and non-PTC who underwent FNAB examination compared with Histopathological at the Anatomical Pathology Unit of General Hospital HAM, Medan. Results: Based on age group, from 62 samples, there were 56.5% PTC aged 41-60 years, (21.0%) 21-40 years, (19.4) and (3.2%) <21 years. There are 80.6% of the samples are female. PTC has a sensitivity value of 28.57%, specificity of 100%, false positive of 100%, false negative of 73.21%, and accuracy of 85.48%. Conclusion: This study can be used as a diagnostic tool for early diagnosis and a fairly accurate monitoring tool, however, a cytological diagnosis is not a substitute for a histopathological diagnosis which is still a definite diagnosis. Malignancy of PTC on cytological examination must be followed by Histopathological as the gold standard. Background: Thyroid nodules are disorders of the thyroid gland, consisting of colloid nodules, cysts, and thyroiditis found in 80% of cases, while benign follicular neoplasms and thyroid carcinomas occur in 10%-15% and 5% of cases. The most common thyroid carcinoma is Papillary Thyroid Carcinoma (PTC), with an incidence rate of about 80% of all thyroid carcinomas. Distinguishing preoperative benign lesions is very important to prevent unnecessary surgery, therefore Fine Needle Aspiration Biopsy (FNAB) is needed, and easy to perform, this examination is the first line in evaluating preoperative thyroid lesions. Objective: Assess the accuracy of FNAB examination compared to histopathological examination in diagnosing PTC. Methods: This study is a diagnostic test. The population of this consisted of secondary data, patients with thyroid nodules diagnosed with PTC and non-PTC who underwent FNAB examination compared with Histopathological at the Anatomical Pathology Unit of General Hospital HAM, Medan. Results: Based on age group, from 62 samples, there were 56.5% PTC aged 41-60 years, (21.0%) 21-40 years, (19.4) and (3.2%) <21 years. There are 80.6% of the samples are female. PTC has a sensitivity value of 28.57%, specificity of 100%, false positive of 100%, false negative of 73.21%, and accuracy of 85.48%. Conclusion: This study can be used as a diagnostic tool for early diagnosis and a fairly accurate monitoring tool, however, a cytological diagnosis is not a substitute for a histopathological diagnosis which is still a definite diagnosis. Malignancy of PTC on cytological examination must be followed by Histopathological as the gold standard.