Bullous lesions may be due to various causes, including bullous pemphigoid, pemphigus vulgaris, linear IgA disease, connective tissue disorders, and other rare vesico-bullous skin diseases. Though histopathology can help narrow down possible diagnoses, direct immunofluorescence is required for a definite diagnosis based on positivity patterns of different immunoglobulins. In this study, 47 cases of clinically suspected immune mediated vesiculo-bullous diseases (IMVBD) were confirmed with histopathology. Females were more commonly affected and the age range was from 10 to 93 years. Among these cases, 23 were diagnosed as pemphigus vulgaris, l6 as bullous pemphigoid, 3 each as pemphigus foliaceus and linear IgA disease. DIF, including testing for c1q, was instrumental for the diagnosis of the disease in order for the patient to get appropriate treatment.