OBJECTIVE The purpose of this study was to evaluate the profile of pediatric oral lesions in northeastern Brazil. METHODS Biopsy records of oral lesions were retrieved from patients aged zero to 18 years who were treated over 18 years in two university hospitals in northeastern Brazil. Routine pathological sections were re-examined and classified into six groups: (1) odontogenic and nonodontogenic cysts; (2) odontogenic tumors; (3) salivary gland pathology; (4) nonodontogenic tumors and tumor-like lesions; (5) bone pathology; and (6) miscellaneous. RESULTS From a total of 4,690 oral biopsies, 564 (12 percent) were from children and adolescents. The largest number of cases was salivary gland pathology, followed by nonodontogenic tumors and tumor-like lesions. The most common oral biopsies were mucocele, pericoronal dental follicle, pyogenic granuloma, dentigerous cyst, and odontoma. Only three cases of malignant tumors were observed. Our results were similar to most studies. CONCLUSIONS Although malignant tumors comprised a small portion of the pediatric oral biopsies, the possibility of their occurrence in children and adolescents should not be overlooked.