Objective: The purpose of the study was to analyze the frequency and distribution of gingival lesions in South Indian population. Study design: A retrospective study of 244 cases of gingival biopsies obtained over a period of 6 years from 1st January 2001 to 31st December 2006 in the Department of Oral Pathology, Government Dental College, Calicut was designed. The lesions were classified into neoplastic lesions and nonneoplastic lesions. Data regarding the age and sex of subjects and the location and type of lesions were obtained from biopsy register for each case. Results: Nonneoplastic lesions accounted for 75.5% of cases with pyogenic granuloma being the most frequent. Neoplasms accounted for 24.5% of biopsies (18% benign, 6.5% malignant). The most frequent benign and malignant neoplasms were peripheral ossifying fibroma and squamous cell carcinoma respectively. Conclusion: This study indicates that there are some differences in the frequency and distribution of gingival lesions in South Indian population. The data presented in this study can be used as a guide for additional multicenter studies in India.