Ganglioneuroma is a rare soft tissue neoplasm, arising most frequently in the mediastinum or retroperitoneum in children and young adults. Correct evaluation of this lesion is of crucial importance, as there are some malignant neoplasms that have similar clinical presentations. As reports of the cytologic appearance of ganglioneuroma are few, the author describes the cytologic features of three patients examined initially by fine-needle aspiration (FNA) with correlation to histology and clinical data. This paper shows that the cytologic features of ganglioneuromas can be diagnostic if both spindle cells and ganglion cells are present in smears. The absence of immature cells and necrosis/inflammation differentiates ganglioneuromas from their malignant counterparts, ganglioneuroblastomas and neuroblastomas. Immunocytochemistry can help to establish the neurogenic origin of the tumor cells.