Subacute granulomatous thyroiditis (SGT) and subacute lymphocytic thyroiditis (SLT) present a similar evolution during the first year, however, posteriorly, except on rare occasions, SGT maintains normofunction while SLT may present relapse with persistent goiter or permanent hypothyroidism requiring periodic follow up. The presence of spontaneous pain and very elevated VSG have been described accompanying SGT but not SLT histologically proven to be used for differentiating these entities. Two cases with clinical criteria and cytological diagnosis of SLT consulted for spontaneous thyroid pain are presented. VSG greater than 50 mm/1st hour was suggestive of SGT. The importance of cytology for the correct management of subacute thyroiditis is emphasized.