Background rnThe kidney is one of the major organs that have essential functions such as maintainingrnelectrolyte balance and ph as well removing waste products among other things. Variousrnneoplastic and non-neoplastic lesions affect the kidneys for which nephrectomy are the standardrnprocedure performed. The indications, however, differ by geographic location , age groups andrntime periods .Therefore ,the aim of this study is to determine the patterns of neoplastic and nonneoplasticrnlesionsrninrnnephrectomyrnspecimensrninrnTASH.rnrn Methods and Materials rnThis was a retrospective cross sectional descriptive study conducted on 174 patients havingrnHistopathologic evaluation of their nephrectomy specimens at Tikur Anbesa SpecializedrnHospital from September 2017 and August 2021. rnResult rn92 (52.9%) of the study subjects were females while remaining 82(47.1%) were male with malernto female ratio of 0.9;1 . Neoplastic diseases accounted for 75.2 percent, nonneoplastic 22.4 and rnmulticystic renal dysplasia 2.3 percent . The mean age of patients was 31.95 with SD 22.127rnwith minimum and maximum age of 6 month and 75 years respectively. The most commonrnneoplatsic indication for nephrectomy was renal cell carcinoma [N=69] constituting 39.7 percentrnfollowed by nephroblastoma 26.4 percent [N=46]. The most common non-neoplastic lesion wasrnCPN with HN accounting for 35.5 percent. rnConclusion rnA wide Histopathologic spectrum of neoplastic and non-neoplastic diseases were found in thernpresent study. There is a decline in non-neoplastic lesions which may be due to early diagnosisrnand treatment.