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Benign breast diseases (BBD) encompass diverse varied conditions under developmental, structural, and inflammatory abnormalities of varying epidemiological profiles across populations. There is not much data from North Western India as the reporting is erratic. The study was undertaken to analyze the patterns and prevalence of benign breast lesions in patients presenting with breast symptoms to a Surgical Oncology OPD in North Western India. The assessment was a 5-year observational study in the Surgical Oncology Department of Sawai Man Singh (SMS) Hospital, Jaipur. It included 5965 patients with biopsy-proven benign breast lesions from multiple accredited pathology centers. Patients with pathologically confirmed malignancies were excluded. Continuous variables are presented as means with standard deviations, while categorical variables are presented as percentages. Data analysis was done using SPSS. Of the 5965 patients, 90.65% were female (n = 5425) and 9.47% were male (n = 560). The most common presentation was a breast lump in 68%, mastalgia in 19%, and nipple discharge in 13%. In women, fibroadenoma was the most frequent diagnosis, accounting for 59.19%, followed by fibrocystic changes 16.02% and inflammatory conditions 9.89%. Among men, gynecomastia accounted for 9.35% of cases. In the majority of patients (70%) with benign lumps, the age was less than 30 years. The mean age of presentation in women was 31.06 years and gynecomastia presented at a mean age of 28.68 years in men. It underlines an important burden of benign breast diseases, especially in the younger age group. Understanding the epidemiology and presentation of BBD is vital to reducing patient's anxiety, avoiding unwarranted interventions, and hence changing clinical management. Further studies are needed in North Western India to refine the screening strategy and improve the patient's care.