Introduction: Thyroid is a readily palpable gland in the anterior inferior neck. Thyroid pathologies are common worldwide and are commonly encountered in clinical practice. Diseases of the thyroid are of great importance because most of them are amenable to medical and surgical management. Thyroid enlargement is a common problem especially in young population causing pressure symptoms and cosmetic deformity. Thyroid lesions may be developmental, inflammatory, hyperplastic and neoplastic. Though FNAC has taken a prominent role on the evaluation of thyroid lesions, thyroid carcinoma closely resembles its benign counterpart making histopathology the gold standard in the diagnosis. Aim of the study is to evaluate the different patterns of thyroid lesions. Methods: Two years retrospective study carried out from July 2015 to June 2017 at SVS Medical college and hospital, Mahabubnagar on 115 biopsy specimens received in the department of pathology. Results: Total number of 115 cases were studied histopathologically out of which 85 were non neoplastic lesions and 30 were neoplastic.Among the non neoplastic lesions multinodular goitre was the most predominant and papillary carcinoma of thyroid in the neoplastic cases.