Granulomatous skin diseases are one of the leading causes of morbidity in tropical countries like Nepal. These granulomatous skin lesions often pose diagnostic challenge to clinicians as well as to dermatopathologists. Histopathologic examination of a biopsy specimen represents one of the most informative and cost-effective procedure and may help to avoid other, costlier and invasive diagnostic workup. Materials and Methods: This cross-sectional observational study from October 2018 to October

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... 019, at department of dermatology, enrolled 142 cases of skin biopsies. Correlation between clinical impression and histopathological findings was evaluated. Results: Out of 13940 dermatology visits/ consultations, 142 (1.01%) skin biopsies were performed. Head, neck and face were the commonest sites of biopsies (29.6%). The most common biopsy technique was incisional type in 70 (50.4%). Histopathology showed granulomatous features in 49 (34.8%) cases, out of which tuberculoid type was the commonest, in 29 (58.0%). Positive clinicopathological correlation was seen in 117/142 (82.4%) for all biopsies and 41/49 (85%) for granulomaous skin lesions. Conclusion: Tuberculoid type was the most common cutaneous granuloma. High clinicopathological correlation in our study supports histopathology as an important tool for diagnosis of granulomatous as well overall skin disorders.