© 2021 John Wiley & Sons LtdAim: We aimed to evaluate the role of Rapid On-Site Evaluation (ROSE) in improving the diagnostic contribution of EBUS-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of granulomatous lymphadenitis. Methods: We retrospectively included all patients in the study who underwent EBUS-TBNA (n = 405) from September 2013 to September 2017. All cases who underwent EBUS-TBNA and were found to have "granuloma" in the final pathological diagnosis (n = 143) were included in the research. Results: One hundred forty-three cases who underwent EBUS and whose final pathological diagnosis was granuloma were included in the study. A total of 231 lymph nodes were sampled. The final diagnosis was found to be compatible with the examination during the procedure for 55 (85.9%) out of 64 patients for whom ROSE was performed. In addition, while 79.7% of the 64 patients who underwent ROSE were tested positive for granuloma, 9.4% were suspected to have granuloma, and no diagnostic result was obtained for 10.9%. The number of lymph node needle aspirations was statistically significantly lower in patients for whom ROSE was performed (P <.001). The final diagnosis was found to be compatible with the examination during the procedure for 55 (85.9%) out of 64 patients for whom ROSE was performed. According to the evaluation made on the duration, the procedure was completed in the first 15 minutes in 95.4% of the patients for whom ROSE was performed, while the procedure took longer than 15 minutes in 93.6% of the patients for whom ROSE was not performed. Conclusion: We found a high incidence of congruence between ROSE and the final cytological diagnosis if granulomas were identified in the final cytology. Performing ROSE shortens the duration of the procedure and reduced sampling thus preventing complications that may occur due to prolongation of the procedure.