10.22376/ijpbs.2019.10.1.p1-12 Volume 8 Issue 2 2017 (April - June) Pilomatricoma is a commonly misdiagnosed, rare, benign skin tumor of the hair follicle matrix. Difficulties persist in the clinical and cytological diagnosis of this lesion inspite of vast increase in the understanding of this entity since 1880. This study was undertaken to improve the preoperative diagnosis of pilomatricoma by analyzing the clinical features and cytological features wherever available. A retrospective study was conducted in a tertiary care hospital of South India over a period of four years from April 2012 to April 2016. Clinical and histopathological features of confirmed cases of pilomatricoma were studied along with the cytological features wherever available. Over a period of four years, 26 cases of pilomatricoma were reported on histopathology and fine needle aspiration cytology was performed in only 6 cases. The tumour was more common in the third decade of life with a slight female preponderance and the commonest location was the head and neck region. Clinical diagnosis of a benign skin adnexal tumor was made in only 1 case. Accurate cytological diagnosis was made only in 4 cases while 2 cases were erroneously diagnosed as epidermal inclusion cyst. Histopathology was considered the gold standard for diagnosis. A high index of clinical suspicion, cytological features of basaloid cells and shadow cells supported by calcification, giant cells, nucleated squamous cells and amorphous debris help in obtaining an accurate preoperative diagnosis though histopathology is still the gold standard. DR PAVITHRA P AND DR ROUMINA HASAN pilomatricoma, benign, basaloid cells, shadow cells. 266-269