Introduction: Bone tumours remain a diagnostic challenge to orthopedic surgeons and pathologists. This leads more concern in developing countries due to limited diagnostic and therapeutic facilities. We analyzed entire spectrum of bone lesions, their demographs like age, sex, anatomical site of occurrence, their relative frequency and histological features in a tertiary care hospital of India. Aim: To study spectrum of various bone lesions and their relative frequency at a tertiary care hospital, Ahmedabad, Gujarat, India. Materials and Methods: This is retrospective hospital based cross sectional study of 103 cases of bone lesions diagnosed on histopathological examination at department of pathology, tertiary care hospital, Ahmedabad, Gujarat over a period of one year. All data were retrieved from clinical case notes of patients. The data was entered in Microsoft excel sheet and analyzed using frequency distribution and percentages. Results: Out of the 103 cases of bone lesions, age ranged from 5 to 71 years with male to female ratio of 1:1. Nonneoplastic lesions were 62.2% with osteomyelitis as the most common pathology accounting 36%. There were 39(37.8%) neoplastic lesions with 59% benign tumours and 41% were malignant tumours. Osteoclastoma (07/23) 30.4% and osteogenic sarcoma (06/16) 37.5% were most common benign and malignant bone tumours detected respectively. Lower end of Femur (19.4%) followed by upper end of tibia (13.5%) were common presenting sites for bone lesions. Conclusion: Bone lesions were common at both extremes of age with no specific sex predilection. Primary bone tumours were mainly benign, occurred predominantly in second decade of life with male predilection. Femur and tibia were common involved sites. Chronic osteomyelitis was the commonest nonneoplastic lesion, while osteoclastoma and osteosarcoma were most common benign and primary malignant bone tumours respectively.