OBJECTIVE To establish morphologic features of xanthogranulomatous cholecystitis (XGC) on fine needle aspiration cytology (FNAC). METHODS In a retrospective, five-year study, ultrasound-guided fine needle aspirates from 17 cases of histologically proven XGC were examined for the presence of histiocytes, foam cells, inflammatory cells, multinucleate giant cells, bile, cholesterol crystals, degenerate cells, normal columnar epithelial cells, capillary endothelial cells and a pink granular background. RESULTS The presence of histiocytes, foam cells, multinucleate giant cells, bile and a mixed population of inflammatory cells in varying proportions on a background of pink, granular debris was characteristic of XGC. However, pleomorphism in reactive histiocytes can occasionally raise the suspicion of malignancy, necessitating a comprehensive evaluation of the overall cytologic findings. CONCLUSIONS XGC has characteristic cytologic features that can be used to differentiate it from malignancy, which XGC can mimic clinically and radiologically. Preoperative FNAC in such cases would help to guide the surgeon toward a correct surgical approach.