Lesions of the lower gastrointestinal (GI) tract account for a substantial source of morbidity and mortality worldwide. GIT endoscopy along with biopsy is an established procedure for investigating a wide range of gastrointestinal conditions. It is not only used to diagnose malignant and inflammatory lesions but is also used for monitoring the course, extent of the disease, response of the therapy and early detection of complications. Hence, endoscopy along with biopsy examination facilitates

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... e diagnosis and early management. Methodology: Patients with lower GI tract lesions were included in the study. Endoscopic biopsies were processed for tissue processing. Haematoxlyne and Eosin stained sections were studied. Observations: Of the 202 colonoscopic biopsies studied, sex ratio was 1.3:1. Study population comprises of cases ranging from 6 months up to 84 years. Diarrhoea of chronic duration was the predominant clinical presentation among 27% of cases. Ulcerated lesion was the commonest endoscopic finding seen among 33% cases. On endoscopic examination, 17% cases had proliferative growth, 14% cases had polypoidal growth and 06% cases showed stricture. Rectum was the commonest site of involvement seen among 38% cases. Non-neoplastic lesions were 119 (59%), benign were 16 (08%) and malignant were 67 (33%). Chronic nonspecific colitis was the predominant non-neoplastic lesion seen among 34% cases. Adenocarcinoma was the commonest malignant lesion contributing for 85% of malignant lesions of lower GIT. Conclusion: Colonoscopy with biopsy examination is the gold standard tool for the diagnosis of lower GI lesions. It is simple, safe, and relatively less invasive with high accuracy. Keywords: Endoscopy, Colonoscopy, Lower GIT, Colorectal cancer, Biopsy.