Background: Renal diseases are an important cause of morbidity worldwide. Nephrectomy is a common surgical procedure done in neoplastic as well as many non- neoplastic conditions affecting the kidney. It is performed in a wide range of clinical conditions that leads to irreversible kidney damage like chronic infections, obstruction, calculus disease, severe traumatic injury, pyelonephritis, nephrosclerosis and renal cell carcinoma. In a developing country like ours chronic pyelonephritis and its variants still continue to be the leading cause of nephrectomies. ToObjective : determine the frequency of occurrence of different histomorphological kidney lesions observed in Nephrectomy specimens over a period of ve years in a tertiary care center. A hospital based ve-year study (Jan 2017 to March 2022) that included 93 cases of NephrectomyMethods : specimens received in the Department of Pathology, RIMS was taken into consideration. The gross and the microscopic ndings were studied for determining the relative frequency and spectrum of different lesions affecting the kidney. Out of 93 nephrectomy specimens, 83 (89.2%)Results : were non neoplastic and 10 (10.8%) were neoplastic cases. Out of the 83 non neoplastic cases 75 (90.3%) were of chronic pyelonephritis and out of the 10 neoplastic cases 8 (80%) were of clear cell RCC and 2 (20%) were papillary urothelial carcinoma (renal pelvis). The neoplastic cases were seen equally in both the genders. The females (67.7%) were more commonly affected then the males (32.3%). The peak age range was between 51- 60 (26.9%) years. Right sided (59.1%) lesions were more common than the left side (40.9%). 35 cases (46.7%) were associated with nephrolithiasis. Chronic pyelonephritis is the most common non neoplastic lesion affecting the kidney which in its early stage is aConclusions: treatable cause for which nephrectomy could be prevented. Therefore, a better insight of the various etiologies needs to be further studied which will help in better patient management.