Background: Large intestine and anal canal harbors various neoplastic and non-neoplastic lesions. Colorectal carcinoma is one of the leading cause of death. This study was aimed to evaluate and correlate the spectrum of various lesions of large intestine including anal canal in relation to age and sex of the patients and to compare the study done in our institute with other studies. Material and Methods: This one year study was done during the period of January 2018 to December 2018 in a tertiary care center which included 58 cases from large intestine and 16 cases of anal canal. All biopsies and resected specimens were fixed in formalin and stained with H&E and special stains like Periodic Acid Schiff (PAS) and Ziehl Neelsen (ZN) were done in required cases. Results: Out of 58 cases of large intestine 36 cases were non-neoplastic and 22 were neoplastic cases. 16 cases from anal canal were non-neoplastic lesions. Adenocarcinoma was the commonest malignant neoplastic lesion. Most of the cases presented with symptoms like bleeding per rectum, abdominal pain and constipation. Conclusion: The present study observed that non-neoplastic lesions were more common in large intestine and anal canal. There was a higher incidence in male patients. Neoplastic lesions were common in 3rd and 4th decade. Adenocarcinoma was the commonest among neoplastic lesions. This study also emphasizes histopathological evaluation is essential for early diagnosis of the tumors which will increase the survival rates of the patients.