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Hepato-biliary masses are very common and need immediate surgical intervention, especially if they are malignant. Some surgeons think that these lesions can be accurately picked and diagnosed by ultrasound and there is no need for confirmation by Fine needle aspiration cytology (FNAC), while others disagree. Objectives To compare the diagnostic accuracies of ultrasound guided FNAC and ultrasound alone, considering histopathology as gold standard.