Objective: Thyroid fine needle aspiration biopsy (TFNAB) is the gold standard in the differential diagnosis of the thyroid nodules. In general, no analgesia is needed before this procedure. However, it is usually believed that the patients may be more comfortable if the procedure is performed under local anaesthetics. In this study, we examined the impact of the use of dermal anaesthetic on the patient's level of discomfort during palpation-guided TFNAB. Methods: Fifty female patients with nodular goitre were enrolled in this study. Patients were randomised into two groups: a placebo cream was applied to group 1 patients (25 females; mean age 47.45 +/- 11.61 years), and local anaesthesia (EMLA (R) 5% cream)was applied to group 2 patients (25 females; mean age 50.89 +/- 12.01 years) approximately 1 h before TFNAB. All patients were asked to mark the pain they felt during the TFNAB on Visual Analogue Scale. Results: The pain scores during TFNAB were 27.73 +/- 20.01 mm and 24.79 +/- 21.98 mm in the placebo group and in the EMLA (R) group respectively. There was no significant difference between the groups (p = 0.496). Conclusions: Topical anaesthesia before palpation-guided TFNAB provides no benefit.