Aim: The study aims to assess the histopathological spectrum of cystic lesions of the ovary in hysterectomy specimens, evaluating their classification, prevalence, clinical presentation, and correlation with patient demographics. The study also seeks to identify potential predictors of malignancy using multiple regression analysis.Material and Methods: This retrospective and prospective histopathological study was conducted on a total of 80 hysterectomy specimens with ovarian cystic lesion. Specimens were received in 10% formalin, processed using standard histopathological techniques, and stained with Hematoxylin and Eosin (H&E).. Clinical and demographic data, including age, parity, clinical presentation, and imaging findings, were recorded. The lesions were classified into functional cysts and neoplastic cysts.The correlation between histopathological findings and clinical data was analyzed using descriptive statistics, and multiple regression analysis was performed to evaluate factors associated with malignancy.Results: The 40-49 years age group had the highest prevalence of ovarian cystic lesions (40.00%), followed by 30-39 years (22.50%). Abdominal pain (37.50%) was the most common clinical presentation, followed by menstrual irregularities (25.00%) and abdominal mass (18.75%). Histopathologically, functional cysts (68.75%) were the most frequent, followed by benign neoplastic cysts (25%), borderline tumors (3.75%), and malignant cystic tumors (2.5%). Right-sided ovarian cysts (47.50%) were more frequent than left-sided cysts (37.50%), with 15.00% of cases being bilateral. Macroscopic analysis revealed clear fluid in 57.5 % cases. Hemorrhagic cysts constituted21.25% of cases followed by cysts with pultaceous contents (6.25%) and mucoid material (3.75%). Few of the cysts revealed septations and solid areas. Multiple regression analysis showed that age (p = 0.7970), laterality (p = 0.8126), and histopathological type (p = 0.8988) were not significant predictors of malignancy.Conclusion: This study highlights the histopathological diversity of ovarian cystic lesions in hysterectomy specimens, with most cases being benign functional and neoplastic cysts. A small proportion (8.75%) were malignant, reinforcing the importance of histopathological evaluation in ovarian cyst assessment. The predominance of right-sided cysts and abdominal pain as the most common symptom underscores the clinical significance of these lesions. Multiple regression analysis did not establish any significant predictor for malignancy, suggesting the need for additional diagnostic markers for risk assessment.