Introduction: Neoplastic and non-neoplastic lesionsof the urinary bladder, cause significant morbidity and mortality around the world. Non-malignant lesions are more incapacitating than lethal. There has been significant progress in understanding their origins and improving methods of diagnosis and treatment, but bladder tumors remain a serious health problem. Objectives: To perform the histopathological evaluation of neoplastic and non-neoplastic lesions of the urinary bladder. Methodology: A retrospective study was conducted at the Basic medical sciences institute JPMC Karachi between 2016 and 2020. All urinary bladder tissue specimens received for histopathological evaluation during the study period were included in the study. Results: A total of 160 patients were assessed between 2016 to 2020. The majority of the patients were above the age of 45 years i.e. 121 (75.6%) while 39 (24.4%) were 45 years or younger. 119 (74.4%) were male patients. A total of 51 patients (31.9%) were diagnosed with low-grade noninvasive papillary urothelial carcinoma while around 24.4 percent were diagnosed with high-grade noninvasive papillary urothelial carcinoma. Almost 20% of the patients were diagnosed with infiltrating urothelial carcinoma with detrusor muscle invasion or squamoid differentiation or both. Only one case of squamous cell carcinoma was diagnosed. One case of follicular cystitis was also diagnosed while 19 patients (11.8%) had acute and chronic cystitis. The majority of the participants underwent transurethral resection of bladder tumor (TURBT). Conclusion: We received a high percentage of patients with low-grade noninvasive papillary urothelial carcinoma as well as infiltrating urothelial carcinoma. Thus, the current study hopes to highlight the high-risk patients and recommends that such patients should be screened so that the neoplastic lesions can be diagnosed early which in turn would improve patient outcomes.