Background: Metastatic tumors represent approximately 3–5% of all cancer diagnoses and commonly manifest at an older age with a slightly higher incidence in men.[1,2] Identifying the primary site of metastasis can be challenging, often requiring multidisciplinary approaches. Fine needle aspiration cytology (FNAC) has proven to be a rapid, cost-effective diagnostic modality for both primary and metastatic malignancies. Nevertheless, additional immunocytochemical (ICC) profiling is frequently needed to accurately determine tumor lineage and subtype.[3] Methods: We conducted a prospective study in the Department of Pathology at V.M.M.C. & Safdarjung Hospital, including 258 patients (213 men, 45 women; age range: 20–90 years) diagnosed with metastatic tumors. FNAC smears were initially assessed using cytomorphological criteria. Clinical information and radiological findings were then correlated to narrow differential diagnoses, and finally, ICC markers were applied in cases with ambiguous cytomorphological features. Data were analyzed using SPSS v17. A P-value of <0.05 was considered significant. Results: Cervical lymph nodes were the most common site of metastatic deposits (n=162; 62.79%), followed by submandibular swellings (n=46; 17.83%) and supraclavicular swellings (n=25; 6.59%). FNAC in combination with clinical details correctly identified 141/258 (54.65%) metastatic tumors—predominantly squamous cell carcinoma (SCC). An additional 13 cases (5.04%) were diagnosed after considering radiological findings. ICC evaluation was crucial for diagnosing 104 cases (40.31%) that were poorly differentiated on routine FNAC. Of these, p63 positivity was indicative of metastatic SCC in 48 cases (48.08%), while Muc-1 was positive in 40 adenocarcinoma cases (38.46%). A tailored panel of ICC markers (CK7, CK20, TTF-1, thyroglobulin, ER/PR, CEA, vimentin, CD10, PLAP) established final diagnoses in the remaining 14 cases. Conclusion: FNAC, supported by clinical and radiological correlation, is a powerful tool for diagnosing metastatic tumors. However, ICC significantly enhances diagnostic accuracy, especially in poorly differentiated malignancies. Integrating these modalities expedites definitive diagnosis, optimizes patient management, and facilitates targeted therapy.