Background: The oral cavity is a common site for pathological lesions; with a wide spectrum of neoplastic and non-neoplastic lesions. They are either symptomatic or asymptomatic. Some lesions may prove to be premalignant and may be a cause of malignancy in the future. Aims and objectives: Our study aimed at studying the spectrum of buccal mucosa lesions and categorizing them into benign and malignant and to study the pattern of these lesions, at a tertiary care center of central India. Materials and Methods: It was a prospective study carried out at L N Medical College from June 2019 to June 2020. A total of 35 cases were meticulously studied in concordance with the age, sex, site and were observed for their histopathological diagnosis and were categorized into non-neoplastic and neoplastic. Results: Of the thirty-five cases studied, we observed eight (22.85%) non-neoplastic and twenty-seven (77.14%) neoplastic cases. In the non-neoplastic category, the predominant lesion is mucocele with four cases, common in the age group of 20-40 years of age. In the neoplastic category with twenty-seven cases, we observed benign (8.4%) premalignant (25.7%) and malignant (42.96%) cases respectively. In the malignant category, the predominant lesion observed is a well-differentiated type of SCC followed by moderately differentiated carcinoma. Conclusion: In our study, we observed maximum cases of neoplastic origin; therefore, accurate and timely detection of premalignant lesions in histopathology (dysplasia, hyperplasia) and early intervention can prevent the disease progression and thus can reduce the surgical burden and would improve the prognosis.