Pediatric soft tissue tumors represent a diverse group of benign, intermediate, and malignant lesions arising from mesenchymal tissues. Their clinical presentation often overlaps, making accurate preoperative diagnosis essential for appropriate management. Fine-Needle Aspiration Cytology (FNAC) is a minimally invasive, rapid, and cost-effective diagnostic technique that can provide valuable preliminary information in children with soft tissue masses. FNAC is particularly useful in distinguishing inflammatory, benign, recurrent, metastatic, and malignant lesions, thereby guiding further imaging, biopsy, surgical planning, and oncological treatment. However, pediatric soft tissue tumors pose diagnostic challenges because of overlapping cytomorphological features, tumor heterogeneity, limited sample material, and the requirement for ancillary tests such as immunocytochemistry, flow cytometry, cytogenetics, and molecular diagnostics. This review discusses the performance, advantages, limitations, diagnostic utility, and practical role of FNAC in pediatric soft tissue tumors. Current evidence supports FNAC as an effective initial diagnostic tool when performed by experienced cytopathologists and integrated with clinical, radiological, and ancillary findings. Nevertheless, core biopsy or excision remains necessary in selected cases for definitive tumor classification, grading, and molecular confirmation.