ABSTRACT Introduction: Prostatic specimens have a wide histological spectrum of benign and malignant lesions. With benign mimickers of prostatic adenocarcinoma, it can be diagnostically challenging in some cases. The present study was conducted to observe the histomorphological spectrum of prostatic lesions, and to evaluate the usefulness of basal cell specific anti-cytokeratin antibody for HMWCK (34ßE12) immunostaining in differentiating benign mimickers from prostatic adenocarcinoma. Materials and Methods: Histomorphology of 229 consecutive prostatic specimens received over a period of six months was studied in this retrospective study. Immunohistochemical staining using basal cell specific antibody high molecular weight cytokeratin HMWCK (34ßE12) was done on 33 cases. Prostatic adenocarcinoma cases were graded according to ISUP 2014 Modified Gleason grading system. Results: Both benign and malignant lesions had a peak incidence in seventh decade of life. Benign lesions accounted for majority of cases (88.21%), of which benign prostatic hyperplasia was the commonest lesion (84.71%). The incidence of prostatic adenocarcinoma was 11.79%. In cases of adenocarcinoma, maximum number of cases were of grade group 5 (40.8%). IHC using HMWCK was useful in 90.9% cases where it either confirmed (81.8%) or changed (9.1%) the diagnosis, thereby improving overall diagnostic efficacy. Conclusion: Morphological spectrum of prostatic lesions is wide. Histopathology remains the cornerstone of diagnosis in most cases. Immunohistochemistry with basal cell specific marker HMWCK is valuable as an adjuvant to histopathology in diagnostically challenging cases.