A retrospective analysis was done of 37 ultrasonically guided fine needle aspirations (US-FNAs) from retroperitoneal, abdominal and pelvic lymph nodes. The cytologic examination diagnosed 15 cases of malignant and 13 of tuberculous lymphadenopathy. The aspirate was normal in the remaining nine patients. On further workup of the last group, five patients turned out to have false-negative cytology. Of them, two had neoplasms, another two had tuberculosis, and one had sarcoidosis. The neoplastic disorders consisted of 7 lymphomas, 5 secondary carcinomas, 2 seminomas and 1 carcinoid tumor. The diagnostic specificity was 100% and the sensitivity 85%. Neither major nor minor complications were encountered in these patients. US-FNA is safe, highly specific and sensitive in diagnosing malignant and tuberculous lymphadenopathy.