The evolution of fine needle aspiration in the United States over the past three decades has overcome the initial concerns of clinicians regarding the accuracy of diagnosis and the potential for disseminating malignancy through the needle tract. The team approach, constant communication between interpreter and clinician, and acquisition of experience minimize the occurrence of false-negative and false-positive results. The procedure is simple and easy to perform, it is safe with rare exceptions, it has patient acceptance, and it has unlimited application in the practice of medicine and patient evaluation.