Peroral fine needle aspiration cytology (FNAC) was carried out on 63 patients with parapharyngeal lesions from January 1986 to March 1992. The age of the patients ranged from 4 to 87 years. Analysis of the results showed 12 inflammatory lesions, 28 benign tumors and 23 malignant neoplasms. Correlation with histopathology showed a diagnostic accuracy of 88.2%, with no false-positive reports. FNAC can replace incisional biopsy, which may be hazardous in this area. Surgery can be avoided for inflammatory lesions.