Urinary bladder lesions, both non–neoplastic and neoplastic are quite common. Neoplasms of bladder pose biologic and clinical challenges. Histopathological analysis of cystoscopic bladder biopsy is the mainstay for diagnosis. The aim of this study was to describe the histopathological spectrum of urinary bladder lesions, their frequency, age wise and sex wise distribution. 140 cases of urinary bladder lesion biopsies were included which were processed and stained according to standard protocol. Out of total 140 cases, four (2.86%) were non–neoplastic and 136 (97.14%) neoplastic cases. In neoplastic cases, High Grade Papillary Urothelial Carcinoma (90 cases, 64.29%) was commonest. Most common affected age group was 61–70 years (45 cases, 32.14%). This study showed male to female ratio was 5.36:1. In Conclusion, Urinary bladder lesions are heterogeneous. Besides, other investigations, cystoscopic bladder biopsies help in the early diagnosis and treatment of various bladder lesions