Background: Head & neck lesions are a common clinical presentation in medicine, and accurate diagnosis is crucial for appropriate management. Accurate diagnosis of head & neck lesions is essential for optimal patient outcomes and can impact treatment decisions, prognosis, and quality of life. Aim: To compare the diagnostic accuracy of frozen section diagnosis with routine histopathological diagnosis of head & neck lesions. Materials & methods: The Karnataka Institute of Medical Sciences, Hubli was the place of the present study from 2016 to 2020, analyzing all specimens for intraoperative consultation at the Department of Pathology. The study used a descriptive research design, requiring specimens to be fresh, normal saline, and without fixative. Exclusion criteria included situations where insufficient biopsy material was acquired, and specimens were placed in formalin fixative.