OBJECTIVE This is a 14-year retrospective histopathologic study of 720 lymph node biopsies. The aim is to document the causes of lymphadenopathy, the age and sex distribution in Lagos. MATERIALS AND METHODS The materials consisted of slides and paraffin embedded blocks of all lymph node biopsy specimens received from within and outside Lagos University Teaching Hospital, Lagos. RESULTS A total of 720 biopsies from 276 males and 444 females were analysed. Chronic non specific lymphadenitis 245 (34%), tuberculosis 125 (17.4%), metastatic lymph node lesions 242 (33.6%), and lymphomas 102(14.2%) were the common causes of lymph node enlargement. The commonest lymph node group affected was the cervical 283 (39.3%). CONCLUSION Malignancy (47.8%) is the most common cause of superficial lymphadenopathy in Lagos metropolis. The age, sex and site prevalence agree with reports from other parts of Nigeria and Africa with minimal variations.