Background: Lung Cancer is a leading cause of cancer-related mortality worldwide. Early and accurate diagnosis using minimally invasive techniques remains crucial. This study evaluates the correlation between cytology and core biopsy in lung carcinoma. Methods: This prospective study was conducted at Sree Mookambika Institute of Medical Sciences from June 2025 to February 2026. A total of 97 cases with suspected lung malignancy and biopsy-proven carcinoma were included. Cytological samples (bronchial wash, brush, and FNAC) were compared with histopathological findings from endobronchial and CT-guided core biopsies. Statistical analysis included sensitivity, specificity, and correlation using p-values. Results: Adenocarcinoma (44.3%) was the most common subtype, followed by squamous cell carcinoma (23.7%) and small cell carcinoma (19.6%). Bronchial brush cytology showed better diagnostic yield than wash, with significant correlation to biopsy (p=0.0001). CT-guided FNAC also showed significant correlation with biopsy (p=0.036), though inadequate samples were noted. Conclusion: Cytology is a valuable initial diagnostic tool but has limitations. Core biopsy remains the gold standard. A combined approach enhances diagnostic accuracy and improves patient management in lung carcinoma.

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