Head and neck paragangliomas are rare at low altitudes but show higher prevalence at high altitudes. The author has confirmed this dictum by diagnosing 191 head and neck paragangliomas on FNAC till December 2023, the largest number reported in the literature. The first case was diagnosed in 1988. Keeping in view the rarity of this neoplasm at low altitudes and the unexplored tumour at high altitudes, a tumour which has given a tough time to cytopathologists world over, the author decided to share his experience in the form of an Atlas. The Atlas includes data of patients up to December 2016 when it was finalised. COVID 19 created lot of disturbance and delayed the publication. In this Atlas the author has given all the necessary details including technique of aspiration and diagnosis by simple MGG stain, relevant clinical data, patient photographs including barely visible to large massive tumours, microphotographs of FNAC smears and detailed histopathology of tumours. The Atlas also includes two unique cases of non-head and neck paragangliomas, one of metastatic pheochromocytoma adrenal presenting as sternal mass and another of urinary bladder paraganglioma presenting with mass in suprapubic region. Both these cases were diagnosed with ease without any discomfort to patients on direct aspiration on MGG stained smears.