Introduction: Children and adolescents display a wide range of oral lesions, including lesions of the oral and maxillofacial hard and soft tissues. The causes of oral health problems in children are unique and distinct from those observed in adult populations. Aim: The purpose of this study was to retrospectively examine pediatric oral biopsies obtained between 2014 and 2021 from an oral and maxillofacial center in Chennai, Tamil Nadu, India, based on age, gender, location, and histopathology. Materials and methods: A retrospective examination of pediatric lesions biopsied over a period of 7 years (2014–2021) was conducted using the data of an institutional referral center for oral and maxillofacial pathology. Patients under the age of 18 were considered pediatric patients. Results: Four thousand sixty-seven biopsies received in the period of 7 years between 2014 and 2021 were examined, 164 of which were taken from pediatric patients. Male to female ratio was 1.5:1. The distribution of the cases was 45 odontogenic pathologies, 25 salivary gland pathology, 20 reactive lesions, 11 connective tissue tumors, 9 fibro-osseous lesions, 20 tumor-like lesions, 9 infectious pathologies, 3 osseous pathologies, and 2 giant cell lesions. Out of these 45 odontogenic pathologies, 35 cases were odontogenic cysts and 20 cases were odontogenic tumors. Conclusion: Biopsies received from the pediatric population were largely odontogenic and salivary gland pathology followed by reactive lesions. Most of them were benign requiring minimal intervention and malignancies were less than 1%. Clinical significance: To identify the incidence and prevalence in oral pathologies in the pediatric population improves the awareness of the various diseases with oral manifestations in children, especially among general and dental practitioners.