Background: This study aimed to characterize the histopathological pattern of lymph node pathology amongSaudi patients and to highlight the age and gender variations of these lesions as base line data. Materials and Methods: We retrospectively analyzed the data from lymph node biopsy specimens received at the Departmentof Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Results: Ofthe 289 lymph node biopsy specimens received, 154 (53.3%) were from males and 135 (46.7%) from femalesgiving a male: female ratio of 1.14:1. Age of the patients ranged from 2.5 to 96 years with a mean age 33.9 years.The commonest lymph node group affected was the cervical (30.4%) followed by axillary (9.7%) and inguinal(8.7%). Malignant lymphoma [71 Hodgkin’s disease (HD), 57 non Hodgkin’s lymphoma (NHL)] 128 (44.3%),reactive hyperplasia 68 (23.5%), and tuberculosis 41 (14.2%) were the common causes of lymph node enlargement.While HD, reactive hyperplasia and tuberculosis were commonest in young adult patients (10-29 years old) andrare above the age of 50 years; NHL was the predominant cause of lymph node enlargement above 50 years. Conclusions: Lymph node biopsy plays an important role in establishing the cause of lymphadenopathy. Amongthe biopsied nodes, lymphomas were the most common (44.3%) followed by non-specific reactive hyperplasia(23.5%) and tuberculous lymphadenitis (14.2%).