Background: Adenocarcinoma of the colon is the most common malignancy of therngastrointestinal tract and is a major contributor to morbidity and mortality worldwide. Byrncontrast, the small intestine, which accounts for 75% of the overall length of therngastrointestinal tract, is an uncommon site for benign and malignant tumors [1] rnOver 1.8 million new colorectal cancer cases and 881000 deaths are estimated to occur in 2018rnaccounting for about 1 in 10 cancer cases and deaths. Overall colorectal cancer ranks third inrnterms of incidence but 2rnndrn in terms of mortality. During 2018, according to Globocan report onrnEthiopia 2878 and 1671 new cases of colon and rectal cancers were diagnosed making colon andrnrectal cancers 5rnthrn and 11th in overall cancer incidence .In the same year 2371 and 1067 cases ofrncolon and rectal cancer patients died which makes them 5rnthrn and 12rnthrn commonest causes of cancerrnrelated death. [2] rnObjectives: The aim of this study is to determine Histopathologic patterns of NeoplasticrnColorectal Lesions in resection specimens in Tikur Anbessa Specialized Hospital. rnrn rnMethods and materials: The study applies retrospective cross-sectional descriptive method tornreview Histopathologic reports of patients with Neoplastic Colorectal Lesions at resection rnspecimens in the five years period (January 2016 to August 2020).The reports are collected fromrnthe pathology data archives and data analysis is done by Using IBM SPSS 23.0.rn rnResult: A total of 208 colorectal resections fulfil the study criteria in the study period. From thisrn117 were males and 91 were females. Majority of the cases are in the 5rnthrn decade of life (41-50rnyears), 25%. The age of the study subjects ranges from the minimum of 19 to the maximum agernof 87 forming the range of 68 and mean of 52.13. The Rectum is most common location (29.5%)rnof the lesions followed by the Sigmoid Colon (24.4%).rnrnAdenocarcinoma (194, 93.3%) is the most common Histopathologic pattern followed byrnNeuroendocrine Tumors (7, 3.4%) and 2 cases (1%) of High risk GIST. From the 194 cases ofrnAdenocarcinoma 111 (57.2%) are Males and 83(42.8%) are Females, male to female ratiorn1.34:1. The mean age patients with Adenocarcinoma is 51.73 and age range is 19-87.The Rectumrn56(30.9%) followed by Sigmoid Colon 47 (26 %) are most common locations. From the totalrncases of adenocarcinoma 41 of them (21.1%) are aged below 40 while 153(78.9%) are agedrnabove 40. rnAdenocarcinoma NOS is most common histologic subtype of Adenocarcinoma 165(85.1%)rnfollowed by mucinous Adenocarcinoma 26(13.4%) and Signet Ring Cell Carcinoma 3(1.5%). rnrnConclusion: This study reveals that majority of the colorectal cancers occur in the RectornSigmoid area, in the 5rnthrn to 7rnthrn decades and more common in males. Adenocarcinoma is by far thernmost common Histopathologic pattern.