Background: Respiratory pathology is the commonest autopsy finding and areresponsible for a great deal of morbidity and mortality. Adult respiratory diseases in the developing world are of increasing concern. 1 This study was undertaken to detect the pulmonary pathology findings in adult autopsy cases as there is limited availability of data. Aim: The aim of present study is to analyse the spectrum of pulmonary lesions in adult autopsy and to correlate the pulmonary pathology with the cause of death given as final autopsy diagnosis. Design: Observational type of study. Material and Methods: This is a prospective and retrospective study wasconducted inTertiary Care hospital, Kalaburagi over a period of 3years from July 2016 to June 2019.A total of 218 lungs of adult autopsies were performed. Autolysed specimens of lungs are excluded from the study. Results: A total of 218 lungs of adult autopsies were performed.All cases showed one or other histopathological lesions in lung.The various pulmonary lesions were classified as pulmonary infection 49 cases (22.2%), COPD 29 cases (13.3%) and pulmonary vascular diseases 140 cases (63.9%). The pulmonary vascular diseases encountered were (CVC) Chronic Venous Congestion (Fig. 4A) (05 Cases, 2.3%), Pulmonary Edema (Fig 2 A,B) (47 cases, 21.5%), Pulmonary Hemorrhage. With Congestion (Fig 3A) (83 Cases, 38%), Acute respiratory distress syndrome (ARDS) (Fig 3B) (04 Cases, 1.8%), Pulmonary Embolism (Fig 5B) (01 Case, 0.45%). Pulmonary haemorrhage with congestion was more frequent in cases of road traffic accident and burns. Chronic obstructive pulmonary disease includes emphysema (Fig 4B) (29 cases, 13.3%).The pulmonary infections encountered were Lobar pneumonia (Fig 1A) (40 cases, 18.3%), Interstitial Pneumonia 04 cases (1.8%), Bronchopneumonia (Fig 1B) (2cases, 0.9%) and 01 cases (0.4%) each of foreign body aspiration pneumonia (Fig 9) ,Lung abscess and Tuberculosis (Fig 5A) respectively. The age ranged from 20 to 80 years. Majority of the cases were in the age group of 30–39 years. 70 cases (32.1%) with M:F Ratio 1.9 :1. The incidental findings in this study are each case of foreign body aspiration pneumonia and Tuberculosis. Conclusion: In this study highlights various lesions in lungs which were confirmed by histopathological examination, which were either incidental or direct cause of death. Irrespective of cause of death, autopsy study is essential to evaluate diseases or injury that may be present and to determine the cause and manner of death.