Background: Gastric mucosal diseases, including chronic gastritis and neoplastic lesions, remain a significant cause of morbidity in Nigeria. Histopathological evaluation of endoscopic biopsies is essential for diagnosis, risk stratification, and management.

Objective: To determine the histopathological profile of endoscopic gastric biopsies at Garki Hospital, Abuja, Nigeria.

Methods: A retrospective descriptive study of 210 gastric biopsies collected between August 2024 and August 2025 was conducted. Histopathological assessment included chronic and other forms of gastritis, Helicobacter pylori infection, and neoplastic lesions. Patient demographics and lesion distribution were analyzed.

Results: Of the 210 biopsies, 126 (60%) were from males and 84 (40%) from females. The majority of patients were aged 41–60 years. Chronic gastritis was the most common lesion (56.2%), with H. pylori-associated chronic active gastritis accounting for 21.9%. Other gastritis types comprised 24.8% of cases. Neoplastic lesions represented 19%, with adenocarcinoma being most frequent (11.4%).

Conclusion: Chronic gastritis, particularly H. pylori-associated, predominates in gastric biopsies at this center, while neoplastic lesions constitute a significant minority. These findings underscore the importance of routine histopathological evaluation, H. pylori management, and targeted surveillance to improve early detection and management of gastric disease.