An oncocyte is a cell containing an abundant amount of deeply eosinophilic finely granular cytoplasm, rounded nuclei, and variable presence of nucleoli in conventional hematoxylin-eosin-stained sections. In the head and neck, a small number of lesions are constructed overwhelmingly of oncocytes; a larger number of nononcocytic lesions composed of cells that imitate this morphology are also encountered. Correlating the fine-needle aspiration cytology and histology of both oncocytic and oncocyte-like neoplasms can assist in avoiding interpretive pitfalls among these lesions.