Background: Endoscopy when combined with biopsy, the diagnostic accuracy get increased manifold. The objectiveof the present study was to diagnose the lesions of esophagus by studying endoscopic biopsies in relation to neoplastic and non neoplastic lesions, sub site wise distribution and correlating them with endoscopic diagnoses. Method: The study included 52endoscopic esophageal biopsies. Result: Out of 52 esophageal biopsies, the neoplastic lesions commonly presented as carcinoma whereas the non-neoplastic lesions presented as inflammatory lesions on endoscopy. Neoplastic lesions predominated and squamous cell carcinoma was the most common lesion. Associated conditions were found to be candidiasis with esophagitis.The most common lesion was squamous cell carcinoma followed by esophagitis. In esophageal biopsies, non-neoplastic lesions showed 83.3% while neoplastic lesions showed 95.0% concordance between the two diagnostic modalities respectively. Conclusion: The conclusion of the study was that endoscopic examination alone might miss out in diagnosing majority of the lesions. So, histological examination in adjunct with endoscopy should be considered as much more valuable diagnostic tool rather than endoscopy alone.