Eight patients with spindle and giant cell carcinoma of the thyroid were seen between 1973 and 1977 at the Medical College of Virginia, representing 12% of all neoplasms of the thyroid in that period. The mean age at detection was 69.2 years. The mean survival was 5.3 months. Fine needle aspiration was performed in six of these eight patients In all six patients the diagnosis could be made cytologically. The cytologic characteristics of this lesion are presented, and the differential diagnosis is discussed.