Introduction and Aim: Various non-neoplastic and neoplastic lesions occur in the kidney. Pathological assessment of gross and microscopic features in nephrectomy specimens is essential for diagnosis and predicts the prognosis in malignant tumours. Materials and Methods: Case records of 46 nephrectomy specimens received between two-year periods were retrieved. Detailed gross and histopathological and immunohistochemical features were studied, and malignant tumours were analysed using CAP protocol. Results: Out of 46 nephrectomy specimens, 17 were non-neoplastic and 29 neoplastic. Males constituted 32 cases and females 14 cases. The commonest non-neoplastic kidney lesion was chronic pyelonephritis with hydronephrosis (29%). The mixed epithelial and stromal tumour was the frequently encountered benign tumour (50%). Renal cell carcinoma was the most common malignant tumour in adults (70%) and Wilms tumour in children (4%). Conclusion: Histopathological examination of nephrectomy specimens helps in diagnosing, staging, and planning the management.