Aim: To assess the prevalence of tooth-related, soft tissue, and intraosseous pathologies in the pediatric population (0–17 years) in a South Indian dental teaching institution and to compare the results with previous literature. Materials and methods: Clinical data from the pedodontics department and histopathological records from the oral pathology department were analyzed from the year 2010 to 2022 and grouped into two major categories: group I, abnormalities of teeth, and group II, intraosseous and mucosal/soft tissue lesions. The data were entered into a Microsoft Excel spreadsheet, and descriptive analysis was conducted using Statistical Package for the Social Sciences (SPSS) software, version 26. Results: In total, 3,398 children under 17 years of age were included. Overall, tooth-associated anomalies were far more common than intraosseous and mucosal lesions. Males were more commonly affected than females. Regarding the laterality of the lesions, the right side was more commonly affected, with the mandible being the most common site. Among tooth-associated anomalies, enamel hypoplasia was the most common. In group II, mucocele, followed by dentigerous cyst, were the most frequently occurring pathologies, with pediatric malignancies being the least common lesions. Conclusion: The pediatric population deserves more attention and care in treatment planning and execution. The presentation of retrospective data from multiple centers across different ethnic groups and geographic areas is warranted for updates.