Background: Space occupying Central nervous system (CNS) lesions have various causes like infections, neoplastic, inflammatory and vascular malformation. CNS tumors account for 2% of all malignancies with incidence of 5-10 per 1,00,000 population. These tumors although rare cause significant mortality and morbidity. The aim of the study was to describe the histological spectrum of CNS lesions and to provide overview of descriptive epidemiology of CNS lesions. Materials and Methods: This retrospective study was conducted in a tertiary care hospital for three years from August 2022 to August 2025.A total of 68 samples were studied. Relevant clinical and radiological details were collected. Diagnosis was done by histopathological examination and classified under World Health Organisation (WHO) categories. Statistical analysis was done. Results: In this study out of the 68 cases of CNS lesions predominant age group was 41-50 years with female preponderance. Primary CNS tumors (76.47%), non-neoplastic lesions (17.6%) and few metastatic cases (5.8%) were received. Common primary CNS tumors were astrocytoma (38.4%) followed by meningioma (32.6%) and schwannoma (15.3%). Least common tumor was craniopharyngioma (1.9%).Non neoplastic lesions comprised of cerebral abscess(33.3%),granulomatous inflammation (25%), epidermal cyst (16.6%), hemorrhage(16.6%) and reactive changes(8.3%). Among the metastatic CNS tumors two were from breast, one from lung and one from gastrointestinal tract. Conclusion: This study highlights the spectrum and frequency of various CNS lesions in a tertiary care hospital. Histopathological examination is gold standard with use of immunohistochemistry in arriving at a definitive diagnosis for treatment and prognosis in neuro-pathology.