Granulomatous skin lesions frequently present as a diagnostic challenge to the pathologist because of various modes of presentation. Both infectious and non infectious causes lead to cutaneous granulomas. Histopathological diagnosis is required to confirm the clinical diagnosis and to classify the cutaneous granulomatous lesions. Aim: To study the spectrum, prevlance and frequency of various types of granulomatous skin diseases according to the age and sex of the patient. Materials and Methods: A cross-sectional type of observational study was carried out in the department of pathology, Rohilkhand medical college and hospital, Bareilly, Uttar Pradesh for the duration of 12 months (November 2018-October 2019). Punch biopsies received were fixed, grossed and processed, with the standard methods and were stained with hematoxylin and Eosin stain. All these biopsies were examined under the microscope and the slides in which granulomatous skin lesions were seen were selected for the study. Special stains were used wherever required. Statistical analysis: The data was analysed using SPSS version 22.0. Results: Out of total 138 cases maximum number of patients belong to the age group of 21-40 years, with male preponderance. Infectious causes were the most common pathology leading to granulomatous skin lesions, with leprosy as the most common etiology. Conclusion: Leprosy is the leading cause of granulomatous skin lesions in this study. Skin biopsies are an integral part of evaluating cutaneous granulomas. Histopathology along with special stains are the gold standard in reaching exact etiology for a final diagnosis.