Background: Gynecomastia is a common benign lesion of the male breast and accounts for up to 80% of male patients referred with beast lesions. Objective: To examine the pattern of breast lesions in male patients who underwent breast biopsy. Methods: All male patients referred to Hatyai Hospital with breast complaints were included in the study. Histopathology reports were retrospectively reviewed during 2004-2011. Results: In 77 male patients diagnosed with breast lesions, the most common lesion was gynecomastia (49/77, 64%), followed by fibrocystic changes (7/77, 9%), and breast cancer (6/77, 8%). Gynecomastia was commonly found in male patients less than 40 years of age, while other breast lesions are seen in male patients over 40 years of age (P = 0.036, OR = 2.842, 95%CI = 1.085-7.447). Conclusion: Gynecomastia was the most common diagnosis among breast lesions in male patients referred to the Hatyai Hospital during 2004-2011. Gynecomastia was more common in the patients less than 20 years old.