Pigmented skin lesions refer to lesions that are black, brown or blue in color. These lesions include both melanocytic and non-melanocytic lesions. A number of pigmented lesions are difficult to classify because of wide spectrum of histological appearances and raise the possibility of melanoma. With this study we intended to evaluate the spectrum of pigmented skin lesions and to correlate the clinical diagnosis with the histological diagnosis. In this retrospective study, 75 cases of pigmented skin lesions were reviewed on hematoxylin and eosin stained paraffin embedded tissue sections from June 2017- May 2020 in the Department of Pathology at a Tertiary Care Hospital and analyzed according to age, gender, site of occurrence and histological types. Out of the 75cases evaluated there were 23 melanocytic lesions and 52 non- melanocytic lesions. Overall, benign melanocytic nevi (13 cases) were commonest lesions followed by seborrheic keratosis (11 cases). The lesions presented from 1st -9th decade with slight female predominance. The most common site involved was head and neck. Clinicohistopathological correlation showed positive correlation in 55(73.3%) cases and negative correlation in 20 cases (26.6%). Pigmented skin lesions are common presenting problem, while majority are benign a small minority can be malignant. A histological interpretation by pathologist is essential to correctly diagnose these lesions in order not to miss a small percentage of malignant tumors and to differentiate melanocytic lesions from its nonmelanocytic mimickers.