Introduction: Cervical lymphadenopathy is a common clinical presentation with a wide range of causes, including infections, reactive processes, and malignancies. This study aimed to evaluate the aetiopathological profile of cervical lymphadenopathy among patients at Dhaka Community Medical College Hospital. Materials and Methods: A cross-sectional observational study was conducted at the Department of ENT and Head-Neck Surgery, Dhaka Community Medical College Hospital, from July 2024 to January 2025. A total of 79 patients with cervical lymphadenopathy were included. All underwent clinical evaluation, baseline investigations, and FNAC. Histopathological examination was performed in cases with inconclusive or suspicious FNAC results. Results: The majority of patients were in the 21–40 years age group (54.4%) and predominantly male (60.8%). Most were from urban areas (70.9%) and lower socioeconomic status (77.2%). FNAC identified tubercular lymphadenitis in 54.4%, metastatic lesions in 17.7%, and lymphoma in 6.3%, while 7.6% were false-negative. Histopathological confirmation revealed tuberculosis as the most common etiology (59.5%), followed by metastatic disease (17.7%), non-reactive lymphadenitis (11.4%), lymphoma (3.8%), necrotizing lymphadenitis (5.1%), and Castleman disease (2.5%). Conclusion: Tuberculosis remains the predominant cause of cervical lymphadenopathy in this setting. FNAC proves to be a reliable first-line diagnostic tool, though histopathological examination remains indispensable in complex or inconclusive cases. Early identification of etiology through a structured diagnostic approach is vital for appropriate management and improved patient outcomes.