Fine-needle sampling (FNS) of 412 pleomorphic adenomas, corresponding to 378 primary tumors and 34 local recurrences, was performed preoperatively in 378 patients. Concordant cytologic diagnoses were established in 376 tumors (91.3%), whereas seven (1.7%) were only classified as benign. Sixteen (3.9%) tumors were considered to be suspicious and two (0.5%) were diagnosed as adenoid cystic carcinomas. Insufficient material for cytologic evaluation was found in 11 (2.6%) tumors. Pleomorphic adenomas were retrospectively classified according to the predominant histological differentiation: chondromyxoid, cellular, myoepithelial, or metaplastic. FNS performances were higher in chondromyxoid than in other types, with 95.2% concordant and 1.4% suspicious/ false-positive, vs. 81.8% concordant, and 11.5% suspicious/false-positive cytodiagnoses, respectively.