BACKGROUND Non neoplastic lesions of appendix outnumber the neoplastic counterparts and appendicitis is the frequently encountered lesion in day to day clinical practice. Both non-neoplastic and neoplastic lesions of appendix present with abdominal pain and thus imaging & histopathological examination of the specimen play an important role in diagnosing the specific entities. In this study, we analysed the macroscopic and microscopic features of the appendicectomy specimen during the study period and ascertained the frequency of non-neoplastic and neoplastic lesions of the appendix. METHODS During the study period i.e. from January 2017 to December 2017, patients who underwent appendicectomy either as an emergency, or an elective procedure, in Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, were included in the study population. The patient particulars and the histopathological diagnosis were retrieved from the surgical pathology records. RESULTS We received 1100 appendicectomy specimens and all were subjected to routine histopathological examination. The histopathological spectrum of appendiceal lesions ranged from non-neoplastic to neoplastic lesions. Non-neoplastic lesions accounted for 99.4% of cases (1093 cases) and remaining 0.6% of cases (7 cases) were neoplasms. Various non-neoplastic conditions like acute appendicitis, acute suppurative appendicitis, chronic appendicitis, eosinophilic appendicitis, fibrosing appendicitis, granulomatous lesion, appendicitis with worm infestation were reported. In this study, primary appendiceal neoplasms like carcinoid tumour, low grade appendiceal mucinous neoplasm (LAMN) and mucinous adenocarcinoma of the appendix were encountered. CONCLUSIONS All appendicectomy specimens should be subjected to routine histopathological examination as certain incidental findings might be missed if histopathological examination of the specimens was not performed.