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Background: A pathological bone lesion can present in any form of inflammatory to neoplastic conditions and they pose a definite diagnostic challenge. The aim of the present research was to study the incidence, age of presentation, and site of bone lesions, overview the clinical, imaging, and pathologic findings, and also compare radiological and histological findings. Methods: This study was conducted in 30 cases of bone lesions, who presented to a tertiary care hospital from May 2010 to September 2012. Clinical examination was done initially, followed by radiological imaging (X-ray, CT & MRI). Based on imaging, the decision of biopsy was taken for final diagnosis. Histopathological examination was done on Hematoxylin and Eosin stained slides. Results: Out of 30 cases, 14(46.66%) cases were benign, 14(46.66%) were malignant tumors and 2(6.66%) were non-neoplastic lesions. Osteochondroma (35.71%) was the most common benign bone tumor and multiple myeloma (28.57%) was the commonest malignant tumor while non-neoplastic lesions were avascular necrosis of hip & chronic osteomyelitis. The primary bone tumors occurred mostly in 0-50 years, while half cases of multiple myeloma and metastatic tumors were seen 1-2 decades higher. 85.71% of benign tumors occurred in males while malignant tumors showed equal sex incidence. All nonneoplastic cases occurred in males. The femur was most commonly involved long bone while the pelvis was the most commonly involved flat bone. Radiological diagnosis was consistent with histopathological diagnosis in 80% of cases. Conclusion: Age, sex, and site are important clinical parameters. Radiology and imaging investigation is an essential

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