Aim: The objective of this study is to define the common causes of both peripheral and visceral lymphadenopathy in Owerri and compare with the previous studies. Methodology: The surgical day books, the histology request, and report forms, as well as the operative findings, were used to retrieve the biodata of patients, history, clinical and histologic diagnoses. Results: The mean age was 37.41 years with age range of 2 to 84 years. The peak age of lymphadenopathy was in the 11-20 years age group. There was a female preponderance giving a male to female ratio of 1:1.2. The commonest disease involving the lymph nodes in this study is metastatic carcinomas which constituted 50% (28 cases). The second commonest lesion was reactive lymphoid hyperplasia which contributed 17.86% (10/56), tuberculous lymphadenitis 14.29% (8/56), the lymphomas constituted 8.93% (5 cases), dermatopathic lymphadenitis and Kikuchi-Fujimoto disease (KF) contributed 3.57% (2 cases) and a single case (1.79%) of chronic non-caseating granulomatous inflammation. Conclusion: Contrary to the previous belief that infectious and inflammatory diseases were the commonest cause of lymphadenopathy in the developing world, this study demonstrated that malignant neoplastic disease is taking a pride of place in lymphadenopathy in our environment.