Background: Gynecological lesions are a common reason for women to seek specialist care. Even benign lesions manifest with a wide variety of clinical features. This study set out to analyze the prevalence of histopathologically evaluated benign lesions of the genital tract and their diverse clinical presentations within a tertiary healthcare institution.Methods: This was a retrospective study of 265 cases of gynecological specimens sent for histopathology at department of morbid anatomy, relevant clinical data on each case was retrieved from patient case notes obtained from the medical records department of the Imo State University Teaching Hospital Orlu, all data were retrieved from these departments from the period of 1st January 2009 to 31st December 2013. Data was analyzed using SPSS version 20.Results: A total of 265 specimens (100%) were received during a 5 year period. The benign lesions seen included; uterine leiomyomas 120 cases (45.3%), cervicitis had 32 (12.1%), there were 22 cases (8.3%) of uterovaginal prolapse, product of conception had 20 (7.6%), cervical polyps and cysts had 11cases (4.2%), adenomyosis and endometriosis had 4 cases (1.5%), serous cystadenoma reported 9 cases (3.4%). Cystic teratoma and simple ovarian cyst had 8 cases (3.0%) each. Endometrial hyperplasia, ovarian thecoma and corpus luteum cyst all had 7 cases (2.6%) respectively. There were 3 cases (1.1%) each of Nabothian cyst and ectopic pregnancy. Fibromas accounted for 2 cases (0.6%). Bartholin’s cyst and hydrosalpinx had 1 case (0.4%) each.Conclusions: Uterine fibroids were the commonest benign lesion for which women underwent gynecological surgery.