Objectives: This study aimed to characterize the cyto pathological and histopathological pattern of thyroid lesions and to highlight the age and gender variations of these lesions. Materials and Methods:We retrospectively analyzed the data from thyroid specimens including FNAC and the surgical pathology samples received at the Department of Pathology, District General Hospital Matara from June 2014 to January 2015.Results: The 1000 specimens, 929 FNAC and 71 thyroidectomy specimens received during the study period came from (95.69%) 887 females and (4.31%) 40 males in FNAC specimens and from (92.95%) 66 females and (7.05%) 05 males. Age of the patients ranged from 04 years to 92 years. 904 (97.3%) cases were found to be non-neoplastic and 25 (2.7%) cases were neoplastic in FNAC and 34 (47.88%) cases were found to be non-neoplastic and 21 (29.57%) cases benign and 16 (22.53%) were malignant lesions in thyroidectomy specimens. The non-neoplastic group in FNAC included: colloid goiter, including both diffuse and nodular goiter (395 cases; 42.5%), colloid cyst (107 cases; 11.5 %) and Hashimoto/chronic lymphocytic thyroiditis (244 cases; 26.6%). In neoplastic lesions in thyroidectomies, there were benign tumors and malignant tumors. Among the benign tumors, 20 were follicular adenomas and 01 was a Hurthle cell adenomas. Papillary carcinoma was the commonest malignant tumor accounting for 50% of all thyroid malignancies, followed by, papillary micro carcinoma (25%) and follicular carcinoma (12.5%).Conclusions: Non-neoplastic thyroid lesions were more common than neoplastic ones. Colloid goiter was the most common lesion. Follicular adenoma was the commonest benign tumor and papillary carcinoma was the commonest malignant lesion.