Aim: to analyze different granulomatous lesions and to find the frequency and etiology of all granulomatous lesions. Materials and Methods: The present Observational study was conducted in the Department of pathology, Anugrah Narayan Magadh Medical College, Gaya, Bihar, India for one year. We include 100 cases of skin biopsies after histopathological confirmation of granulomatous lesions. Results: Among 80 cases were studied in which male predominance was noted with 46(57.5%) cases and females constituted 34(42.5%) case providing M:F ratio of 1.4:1. Most of the patients were noted in age group of 20 to 30 years i.e 30(37.5%) cases followed by 17(21.25%) case in 30 to 40 years. 83.75% of cases were seen below 50 years of age in our study. Infectious granulomatous dermatoses were very common, only 1.25% cases of sarcoidosis was found. Most cases of infectious dermatoses were noted in 20 to 30years comprising 30(37.5%) cases. Leprosy remained the significant causative reason for infectious granulomatous dermatoses succeeded by tuberculosis of skin. Borderline tuberculoid leprosy was found to be predominant, constituting 22 (27.5%) cases followed by indeterminate 17(21.25%) and lepromatous leprosy had 15(18.75%) cases, tuberculoid leprosy 15(18.75%) case and 6(7.5%) of borderline lepromatous. Lupus vulgaris constituted 2 cases (2.5%) and only 1 (1.25%) case of sarcoidosis was found. Conclusion: Histopathology is still a gold standard tool in classification of granulomatous lesions and with support of special stains we can arrive at exact etiology to meet out appropriate treatment.