Objective: The purpose of this study is to determine the prevalence and features of oral and maxillofacial lesions found in the residents of Al‐Qassim region, Saudi Arabia.Methods: A retrospective study was conducted at King Fahad Specialist Hospital, Buraidah, Qassim, KSA. The data for all biopsied oral and maxillofacial lesions were retrieved from January 2014 until August 2022. All patients’ data including age, gender, location of the lesion, and histopathologic diagnosis were reviewed and analyzed using IBM SPSS version 23 and Microsoft Excel.Results: A total of 381 oral pathology biopsies for individuals aged 18 and above were included in a descriptive analysis. One hundred ninety five (51.18%) of patients were male, and 186 (48.82%) were female. The site most commonly biopsied was the oral mucosa (26%). The diagnosis was categorized according to the histopathological diagnosis into 13 categories including all pathological lesions in the oral and maxillofacial area. The frequently biopsied category was soft tissue pathological lesion category (26%), second to that is the odontogenic cyst category (22%), and third is the immunological‐mediated lesion category (13%). The sub‐diagnosis that was mostly observed was radicular cyst, lichen planus, and focal fibrous hyperplasia with the percentages of 13.6%, 10.8%, and 9.4%, respectively.Conclusion: The findings provide important information about the oral and maxillofacial pathology in Al‐Qassim region, Saudi Arabia. This study found that biopsied oral lesions were more prevalent in males and in patients in the fourth decade of life. The oral mucosa was the most biopsied site, and the majority of the biopsies were soft tissue pathological lesions and radicular cyst was the most frequent diagnosis. Knowledge of such demographic and clinical features of oral and maxillofacial pathology cases helps in prediction of disease incidence and subsequent proper patient care in the region.