Echo-guided aspiration biopsy cytology (EGABC) performed for nodular goiter in the past 3 years was evaluated in 605 cases. A correlation of cytologic findings with histologic findings was possible in 127 patients who underwent surgery. Fifty-two of 62 cancers diagnosed histologically were cytologically positive (83.9%), 4 were suspicious (6.5%) and 6 were negative (9.7%). EGABC of the thyroid is an excellent method for eliminating unnecessary operations in patients with thyroid nodules.