Introduction:Intracranial and spinal mass lesions are an important cause of neurological morbidity and common indication for cross sectional imaging. Given the wide range of pathological cases that can present as intra cranial mass lesions, the radiologist has an important role in limiting the differential diagnosis in clinical decision making process and in further management of cases. so far there are few reports on radiological and histological and pathology correlation done in Ethiopia and no report done giving emphasis on cases discussed on inter-departmental management session ; like , pre-operative Neurosurgery and radiological session. Thus, this research contribute the knowledge of the imaging appearance of various intracranial tumors and subsequently to improve the diagnostic accuracy and role of radiology in the management decision . Objectives:To assess the correlation of preoperative radiological diagnosis of lesions with histological diagnosis in TikurAnbesahospital , Addis Abebea , Ethiopia , from January 2016 to August 2017 G.C. Methods:Hospital based prospective cross- sectional study was conducted on 78 patients who underwent surgery for the intra-cranial and spinal lesions at TikurAnbessa Specialized Hospital in a period of 21 months from January 2016 to August 2017 G.C. Patients included here are those who had either CT or MRI or both report with confirmed histopathology result. Result:There was morethan 80 % of concordance between pre operative radiologic diagnosis and histological diagnosis based on based on top diagnosis and first differential diagnosis given on neuro- radiology and neurosurgery joint session discussion in imaging evaluation of Glial tumor , Menigioma and Sellar/Parasellarregin tumors. Conclusion:Glial tumor and Meningioma were the most frequent intracranial tumors presented. It was seen that pre operative radiologic diagnosis accuracy was high for most of intracranial tumor.