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Background and purpose: The prevalence of malignancy in thyroid nodules have been reported 1-10%. Epidemiological studies suggest that thyroid cancer incidence is rising over the last 20 years. The aim of this study was to evaluate the results of fine needle aspiration of thyroid nodules in patients referred to Imam Khomeini hospital in recent decades (2003-2011) in Sari. Materials and methods: This is a cross sectional, retrospective study. The results of cytology were recorded and compared with pathology results. The sensitivity, specificity, positive and negative predictive value of fine needle aspiration for prediction of malignancy were assessed. Results: The study population included 2002 patients with thyroid nodules, 210 cases were male (10.5%) and 1792 women (89.5%). Cytology results in 1598 cases (79.8%) were benign, 205(10.2 %) unsatisfactory, 53(2.6 %) suspicious and 146 (7.3 %) malignant. 217 reports of pathology results of patients with thyroidectomy were available, 153(70.5%) specimens were benign and 64 (29.5%) malignant. The sensitivity of fine needle biopsy was 81.2% and specificity, 75.1%. positive predictive value(PPV) and negative predictive value(NPV) were 63.4% and 93.5 percent respectively. Conclusion: According to the results of this study, thyroid fine needle aspiration is still a good way to predict thyroid malignancy and the incidence of thyroid malignancy in our patients has not increased in recent decades.