Background: Diseases affecting the prostate include benign prostatic hyperplasia (BPH), non-specific inflammatory conditions and malignancy of the prostate, are responsible for significant morbidity and mortality among ageing male patients.This study was done to study the histopathological spectrum of prostatic lesions, classify them and to correlate them with free serum PSA levels. Material and methods:The sample size was 302. Collected data was analyzed with descriptive statistics followed by chi- square test.Tests were used to analyze the sensitivity, specificity and overall accuracy of serum PSA levels in diagnosing benign and malignant prostatic lesions. p value was calculated and considered statistically significant when p value was less than 0.005.