Information on cancer patterns is an important basis for determining the priorities for cancer control indifferent countries worldwide. There is no reliable information about the incidence or pattern of cancer inNepal and hence an attempt was made to assess the situation based on hospital data which is the only source inthe western region of Nepal. Cancer cases diagnosed by all methods or treated in Manipal Teaching Hospital,affiliated to Manipal College of Medical Sciences, Pokhara, during 1st January 2003 to 30th May 2005 wereused for the present study. A total of 957 cancer cases were identified with a male to female ratio of 1.1:1. Themedian age of male and female patients was 63 and 60 years, respectively. The proportion of microscopicallyconfirmed cases, both from primary and metastatic sites was 87.5% and tobacco-related cancers constituted48% of all cancers among males and 28% among females. For males the leading cancer sites were lung (22.2%),larynx (9.8%) and stomach (9%) and that for females was lung (20%), cervix (19.7%) and breast (7.8%). Amongmales, 33.1% of all cancers were in the respiratory system followed by digestive organ cancers (23.2%). Amongfemales, 28.4% cancers were related to the reproductive system, 22.8% to the respiratory system and 14.1% todigestive organs. The cancer pattern revealed by the present study provides valuable leads to cancer epidemiologyin Nepal, particularly in the western region, and provides useful information for health planning and futureresearch.