Background: Head and neck lesions include a spectrum of pathological lesions ranging from simple benign to highly malignant entities. These lesions contribute significantly to morbidity and mortality of patients. The aim of this study was to determine the histological patterns of head and neck lesions, both non- neoplastic and neoplastic and to analyse the data in relation to age, gender, topography.Methods: A two year retrospective study was conducted in the Post Graduate Department of Pathology, ASCOMS and Hospital and histopathological data pertaining to all head and neck lesions was reviewed. Each case was analysed with respect to age, gender, site and histological type.Results: One hundred and forty-five cases from the head and neck region were analysed during this two-year period. Age range was from 3 months to 85 years with maximum cases in the age group of 21-50 years (51.03%). The Male: Female ratio was 1.37:1. In our study, 53.79% benign, 24.13% inflammatory and 22.06% malignant cases were recorded. Maximum number of benign lesions was in the age group of 21-50 years. Malignancies were noted to be higher in ages 51 years and above. Squamous cell carcinoma was the most common malignancy observed.Conclusions: We conclude that site specific data like this is helpful in evaluating patterns of head and neck lesions and augment the base line data of institute and the region.