Introduction: A variety of non-neoplastic and neoplastic lesions involve the nasal cavity (NC), paranasal sinuses (PNS) and nasophyrynx (NP) and these are very common lesions encountered in clinical practice. Among this granulomatous and neoplastic lesions are important for both ENT surgeon and Pathologist. Exact diagnosis of the lesions can affect treatment as well as prognosis. Objectives: To study the clinical and histopathological features of various lesions of NC, PNS and NP. Methods: In the present prospective study, total number of 50 cases (male 35, female 15; age group ranging from less than 1 y to 76 y) of space occupying lesions of NC, PNS and NP over the period of 24 months (from September 2009 to September 2011) with presenting history of lesions in NC, PNS and NP to ENT department were investigated and included. All tissues after fixation in 10% buffered formalin, processed and then stained with Hematoxylin & Eosin to study various histopathological patterns. Photographic documentation of macroscopic appearance of lesions and histopathological correlation of clinical diagnosis was done. Results: The non-neoplastic lesions are more common than neoplastic lesions in age group of 20-30 years with male predominance. Among NC, PNS and NP masses, there were 41 (82%) non-neoplastic and 09 (18%) neoplastic lesions. Inflammatory polyps (89.5%) were the most common among the non-neoplastic masses; squamous cell carcinoma (46.15%) was the commonest out of all malignant masses. Conclusion: It is difficult to comment on nature of polyps, by clinical examination and gross examination of specimen and hence histopathological examination is mandatory for diagnosis and management.