This report describes the fine needle aspiration cytologic findings of 22 cases of basal cell carcinoma of the skin. The series consisted of 17 men and 5 women with a mean age of 60.7 years (range, 35-80). All the patients were from south of Xinjiang and were outdoor workers with histories of prolonged exposure to strong sunlight. Histopathologic study was performed in all cases. Using fine needle aspiration cytology (FNAC) in evaluating basal cell carcinoma, there were no false-positive cases, but one false-negative one giving a diagnostic accuracy of 95.65%. Cytologic features suggestive of basal cell carcinoma included increased numbers of small, uniform hyperchromatic, relatively little cytoplasmic cell clusters. The peripheral cells appeared in monolayer form as a papillated outline with very strong cellular cohesion. Scattered tumor cells were seldom seen. The differential diagnosis of basal cell carcinoma in FNAC includes poorly differentiated squamous cell carcinoma, eccrine gland carcinoma, and neuroendocrine carcinoma of the skin. FNAC diagnosis of basal cell carcinoma is essential in order to ensure proper treatment.