Background: The epidemiology of biopsy- proven renal disease (BPRD) provides information that is useful for clinical practice and investigation. India lacks a national renal data registry system and there is a scarcity of information on the pattern of BPRD in South India. Objectives: To determine the occurrence and analyse the epidemiology of BPRD in our local (South Indian) population. Material and Methods: A retrospective review of reports of native renal biopsies performed on patients at a tertiary care hospital in South India, from 2008 to 2013 was undertaken. All renal biopsies were studied by light and immunofluorescence microscopy and were classified into primary glomerulonephritis (PGN), secondary glomerulonephritis (SGN), tubulointerstitial nephritis, vascular nephropathy, hereditary nephritis, end stage renal disease and biopsies exhibiting no significant pathology. Results: A total of 661 cases were included in the study. The most common clinical syndrome as an indication for renal biopsy was NS (29%). PGN was the most common BPRD, accounting for 42.3 % of the cases. Minimal change disease (33.6%) was the commonest PGN followed by membranous nephropathy (15.7%) and focal segmental glomerulosclerosis (12.6%). Diabetic nephropathy (76.9%) was the commonest SGN (14.7%) followed by lupus nephritis. Conclusion: Our study represents an important contribution to understanding the epidemiology of renal disease in South India. The distribution pattern of PGN largely corresponds to the distribution pattern described in other South Indian studies. However, there is a wide variation of major histologic patterns of PGN across the world.