Breast lesions encompass a wide spectrum of diseases, both neoplastic and non neoplastic. The current upward trend in incidence of malignant breast lesions has also been accompanied by development of hormone receptor based targeted therapy. However, effective treatment of breast lesions necessitates early and conclusive diagnosis. This calls for a multidisciplinary approach which includes clinical assessment, radiological examination and pathological tools like FNAC, Frozen section and Histopathology. This study was conducted to compare the diagnostic accuracy of FNAC and frozen sections in differentiating benign and malignant lesions of the palpable breast lumps cytology using histopathology as gold standard. A one year prospective study was conducted from June 2011 to July 2012. It included 70 clinically palpable breast lumps referred to the Department of Pathology, Silchar Medical College & Hospital for FNAC, frozen section and histopathological evaluation. Result and Conclusion: According to this study, fibroadenoma (25.71%) was the commonest benign and invasive ductal carcinoma (48.57%) was the commonest malignant lesion. The most common age group of malignancy of the breast was (41-50) years. Malignant lesions were more common in the left breast (55.71%). Benign lesions of breast were commoner below 40 years of age, where as malignant lesions were more common above 40 years of age. Sensitivity of Fine needle aspiration cytology was 99.11%, specificity 96.88%, positive predictive value 97.22%, negative predictive value 91.18% and accuracy 94.29%. On the other hand sensitivity of frozen sections was 97.37%, specificity100%, positive predictive value100% and accuracy 98.57%. FNAC is thus a rapid, cost-effective highly sensitive and highly specific first minimal invasive method in diagnosing breast lumps. But Frozen is more sensitive and specific than FNAC and has also a definite role in settings like; difficult cytology, evaluation of lumpectomy margins and intra operative nodal status.