Background: The female genital tract includes vulva, vagina, uterus, cervix, fallopian tubes, and ovaries. The common sites for the development of the neoplastic lesions are cervix, endometrium, myometrium and ovaries. Histopathological diagnosis is still considered as the “gold standard” in the assessment of cervical lesions; however, the histopathological assessment of these lesions is limited to the interpretation of the morphology, with little to no information regarding the risk of persistence, progression, or regression. The present study was conceived to correlate the clinical diagnosis and the histopathology of lesions of uterine cervix. The cases studied during this period were classified as clinically evident malignancy, clinically suspicious of malignancy and those cases where there was no clinical suspicion of cervical malignancy. Materials and Methods: This study was carried out on the rural population in a tertiary care hospital at Kerala on 365 cases where the data and histopathology slides were retrieved from the hospital records from July 2015 to June 2018. Results & Discussion: A total of 365 cases were studied and among these specimens, the cervical lesion specimens 93, endometrial lesion specimens 82, myometrial specimens 118, ovarian lesion specimens 68 and vaginal lesion specimens were 4 studies. Among 93 Cervical lesion specimens, number of hysterectomy samples, cervical punch biopsy samples and cervical polypectomy samples were 12, 69, & 12 respectively. Among 82 uterine endometrial lesions specimens, the number of hysterectomy specimens, Dilatation and Curettage and Endometrial polypectomy were 33, 46 & 3 respectively. Among 68 ovarian lesion specimens, the number of pan hysterectomy, TAH & USO, Oophorectomy & tubo-ovarian mass were 22, 6, 38 & 2 respectively. Adenomyosis was the most common non-neoplastic lesion and leiomyoma was found to be most common benign tumour. Most benign tumours were reported in the age group of 41-50 years group. Conclusion: In this study, adenomyosis was found to be most common non-neoplastic lesion and leiomyoma was found to be most common benign tumor in female genital tract of 4th & 5th decades. Uterine cervix lesions were contributed majority of premalignant as well as malignant lesions.