INTRODUCTION: Frozen section (FS) analysis is an integral part of daily work-up of the surgical pathology department which require teamwork of pathologists, residents and technical staff. The aim of the study was to evaluate the accuracy and determinants of FS diagnosis, compared with the final histological diagnosis. METHODS: The study included FS requisitions received in the Pathology department, from March 2020 to March 2022. Intraoperatively, tissue samples were processed and reported as per the standard FS protocol. Definitive histopathological diagnosis was made by examining sections of formalin fixed paraffin embedded (FFPE) block prepared from the remaining tissue after FS examination. The results of FS diagnosis were then compared with the final histopathological diagnosis. RESULTS: Total 531 requisitions of FS analysis were received. Maximum requisitions came from surgeries of head and neck (41.05%) followed by genitourinary (17.89%) and others. The FS and FFPE histology were concordant in 519 (97.7%) cases while 5 (0.9%) cases were deferred. Overall specificity, sensitivity, PPV and NPV of FS examination as compared to final histopathology were 97.82%, 99.79%, 97.82% and 99.79%. CONCLUSION: Pathologists should be well aware of the procedure, errors, troubleshooting and should be competent enough to arrive at the most conclusive diagnosis as early as possible which will have definite consequences on patient management. Periodic review of the correlation between frozen section (FS) diagnosis and final diagnosis is very useful and can serve as a measure of an institutional quality of service.