Objective: The aim of this study was to evaluate the clinicopathological features of oral lesions in children and adolescents diagnosed in an Oral Pathology Laboratory. Study design: Between 2000 and 2010, all oral lesions diagnosed in patients younger than 18 years old, from the Oral Pathology Laboratory, Federal University of Pernambuco, Brazil, were selected for the study. The clinical data were obtained from the patient charts filed in the Laboratory. All cases were microscopically reviewed and the diagnosis classified into 10 categories. Results: From the 2395 lesions, 315 (13.1%) occurred in this age group. The lesions were more common in the female gender (59%) during the second decade of life (69%). The inflammatory/reactive lesions were the most common (64.4%), followed by the epithelial and soft tissue neoplasms (8.6%). The mucocele (33.3%) was the most common lesion, with the lip mucosa representing the most affected site (48%). In 61.5% there was concordance between clinical hypothesis of diagnosis and histopathological diagnosis. Conclusions: Inflammatory/reactive lesions were the most common biopsied lesions and the lip the most frequent site. Similar studies are important, reinforced by the low correlation between clinical diagnosis and histopathological diagnosis.