Background: Chronic colitis, regardless of type, is defined histologically by chronic inflammation, mainly plasmacytosis, in the lamina propria. Specific diagnosis of chronic colitides in biopsies can be challenging for practicing pathologists. The present research was undertaken to study complete clinico-pathology of chronic colitis, pathological pattern and spectrum of colitis, also study correlation of colonoscopy and histopathology of these lesions.Method:This study was a retrospective and prospective analysis of 187 cases ofhistopathologicallyproven colitis on colonic biopsies over a period of 5 years from June 2015 to May 2020. Results:Majority of specimen were rectal biopsies (57.22%) followed by mapping biopsies (34.22%). Of 85 cases where both colonoscopy and histopathology diagnosis was available, 61 (71.76%) colonoscopy diagnosis were consistent with histopathology. Among 187 cases, 107 were inflammatory bowel disease (57.22%), they were further sub classified as ulcerative colitis (UC) (96.26%), Crohn’s (0.93%) and indeterminate colitis (2.8%). Cases of UC had features of basal plasmacytosis (97.19%), crypt distortion (93.45%), crypt loss (70.09%) and goblet cell depletion.48cases diagnosed as non-specific colitis. Infectious colitis comprised 8.56% of total colitis cases. It included tuberculosis 4 (2.14%), CMV colitis 2(1.07%) and 5.35% cases of acute self-limiting colitis. 5(2.67%) cases were diagnosed as lymphocytic colitis and 2 cases showed focal active colitis. Also, found single case of eosinophilic colitis and radiation proctitis each.Conclusion:Good clinico-pathological correlation helps to reduce number of cases diagnosed as non-specific colitis. To improve the detection rate of microscopic colitis, it is important to take multiple biopsies from normal looking colon on colonoscopy.