Despite the advantages of speed and accuracy in diagnosis during surgical procedures, intraoperative cytologic techniques are not widely used. The authors evaluated the diagnostic accuracy of intraoperative scrape cytology using lymph nodes referred for the detection of metastatic tumor. The cytology results were compared with the results of frozen and permanent sections. Of the 79 cases examined, 17 cases harbored metastatic carcinoma. The scrape cytology revealed metastatic tumor cells in all 17 positive cases(100%), while the frozen section failed to detect metastasis in 3 positive cases(82% accuracy). Thus we believe intraoperative scrape cytology can enhance diagnostic accuracy if combined with the conventional frozen section, and may replace it. This technique is safer, easier, faster and more economical than the conventional frozen section method.