Aim: To evaluate the histopathological patterns of different cutaneous granulomatous lesions. Materials and Methods: The present cross-sectional observational study was conducted in the Department of Pathology,Lord Buddha Koshi Medical College and Hospital, Saharsa,Bihar, India. For 1 year. This cross sectional study enrolled 120 cases of skin biopsies after histopathological confirmation of granulomatous lesions. Results: Among 120 cases were studied in which male predominance was noted with 73(60.84%) cases and females constituted 47 (39.16%) case providing M: F ratio of 1.5:1. Most of the patients were noted in age group of 20 to 30 years i.e. 45(37.5%) cases followed by 23 (19.17%) case in 30 to 40 years. 85% of cases were seen below 50 years of age in our study. Infectious granulomatous dermatoses were very common, only 2 cases of sarcoidosis were found. Conclusion: Tuberculosis, fungal infection, and foreign body reaction were the most frequent causes of cutaneous granuloma. The two popular subtypes of leprosy is borderline tuberculoid leprosy and tuberculoid leprosy.