Background: Skin diseases constitute a major public health problem. The pattern of skin diseases vary from one country to another country. Disease pattern also vary from tissue reactions to vesiculobullous lesions and malignant lesions. Aim: To analyze the clinico-morphological spectrum of skin lesions. Methods: A retrospective study was undertaken to determine the clinico-morphological spectrum of skin lesions from all the skin biopsies, received from Jan 2009 to Aug 2011 (2 and __ampersandsignfrac12; years) in the Department of Pathology, Vinayaka Mission__ampersandsignrsquo;s KirubanandaVariyar Medical College, Salem. Results: A total of 178 cases were reviewed and analysed. The highest number of patients were in the age group of 51-60 years.The incidence of dermatological diseases was more in male patients than female patients. Cystic lesions (26%) were the commonest lesions followed by infectious diseases of skin (13.4%), malignant tumors of skin (13%), alteration in the dermal collagen (8%). Most common site for various skin lesions was extremities followed by scalp region. Clinically the lesionswerevarying from papule, macule, vesicles, nodules to ulcers. The two major tissue reaction patterns, the psoriasiform and the lichenoid reactions were commonly seen in this study. Conclusion: In our study, cystic lesions, infectious diseases and malignant tumors of skin were the most common disorders. The contribution of histopathology to the final diagnosis and there by treatment were significant.