Introduction Fine needle aspiration(FNA) of cystic adult granulosa cell tumors(CAGCT) has been sporadically reported in the literature. We undertook a retrospective study to further elucidate the cytologic features on FNA material in order to avoid possible misinterpretation with other primary tumors of ovary. Materials and Methods During 1992 and 2014, FNA of five cases of CAGCT were recorded. Results The patient's age ranged from 28 to 62 years. One was bilateral and all cases involved right side of ovary. The size of tumor was 5.5 to 10 cm. FNA of the five CAGCT show similar cytologic features except one case. Four cases contained a background composed of histiocytic cells and debris material. The tumor cells were small with round to oval nuclei and fine chromatin pattern, inconspicuous nucleoli, scanty cytoplasm with rare intranuclear longitudinal grooves. Tumor cells were arranged in small groups as well as single cells were appreciated some of which were deprived of cytoplasm. Microfollicular or rosette pattern were vague, some of which contain amorphous material resembling Call-Exner bodies. In addition, two cases also showed prominent papillary component and one of which was misdiagnosed for serous papillary carcinoma. All five cases were surgically resected and CAGCT was confirmed. Conclusions FNA of CAGCT of ovary can be a challenging diagnosis as classic cytologic features may not be present and can be confused with benign follicular cyst especially when the ultrasound study favor benign cystic lesion. Rarely this tumor may show prominent papillary component and can be confused for a more clinically aggressive tumor such as papillary serous carcinoma.