Intracranial space-occupying lesions (ICSOLs) include neoplastic and non-neoplastic lesions of the central nervous system. “In India, central nervous system neoplasms account for approximately 1.9% of all malignant tumours.” Biopsy and histopathology are essential for accurate diagnosis and preventing incorrect therapeutic interventions.The study aims to correlate histopathological and radiological diagnosis of intracranial lesions. Epidemiological parameters of various neoplastic and non-neoplastic intracranial lesions according to age, sex and site are assessed.The retrospective and prospective descriptive study, conducted at the tertiary care centre, analysed 104 cases of ICSOLs. The study utilised preoperative radiological reports, MRI (Primarily) or CT scan. The statistical analysis was performed using STATA (14.2). Frequencies and the chi-square test were used for calculation.In the present study, neoplastic lesions (93.27%) were more common than non-neoplastic lesions (6.73%), with a male predominance (Male: Female = 1.36:1). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of radiological diagnosis in neoplastic lesions were 98.97%, 28.57%, 95.04%, 66.67% and 94.23% respectively, compared to histopathological diagnosis. P-value <0.05 suggests statistically significant results.The study found a higher incidence of neoplastic intracranial lesions, likely due to the institute's fully functional oncology department. Radiological techniques offer non-invasive insights into lesion characteristics, while histopathological examination provides a definitive cellular-level diagnosis. Together, these methods enhance diagnostic accuracy, guide treatment decisions, and improve patient outcomes.