Granular cell tumor rarely occurs in the thyroid. This case report describes the cytologic features of a granular cell tumor seen in a fine needle aspirate obtained from a 27-year-old woman with a gradually enlarging thyroid nodule. The aspirate showed single as well as syncytial clusters of cells with abundant granular cytoplasm. The differential diagnosis in this case included granular cell tumor, Hurthle cell lesion/neoplasm, and a histiocytic reparative process. Immunohistochemical studies, including S-100 protein and CD68, performed on a cell block preparation were helpful in supporting the diagnosis. Diagn. Cytopathol. 2013;41:825–828. © 2012 Wiley Periodicals, Inc.