Author(s): Sulata Choudhury BACKGROUND Intraoperative squash smear cytology is an important diagnostic tool; it guides the neurosurgeon during surgical resection; it also helps the surgeon to monitor and modify the approach to surgery. Hence prompt and correct diagnosis is essential for early intervention. In the era of stereotactic biopsies where the amount of tissue is very small, accurate diagnosis is imperative and it can be achieved with squash cytology which is a simple, cost effective and rapid technique. In this study, we have assessed the diagnostic accuracy of squash cytology by comparing with histopathological examination. MATERIALS AND METHODS This was a prospective study conducted in department of Pathology in S.C.B Medical College Hospital for a period of two years from June 2016 to May 2018. The study subjects were 73 consecutive patients operated for tumours of nervous system in department of neurosurgery. Complete clinical and radiological findings were recorded. During surgery, small bits of tissue measuring 1-2 mm2 were removed and sent in a gauge moistened with saline for squash cytology. The squash smears were correlated with histopathological examination. RESULTS Astrocytoma (31.51%) was the most frequently encountered tumour followed by meningioma (28.77%) and schwannoma (13.70%). Peak incidence of brain tumor was observed in 41-50 years age group. The overall diagnostic accuracy of squash cytology in the present study was 84.93%. CONCLUSION Squash smear cytology proved to be simple, inexpensive, rapid technique for intraoperative consultation of CNS tumours and also aids the neurosurgeon for further proper management.