Abstract : Gynaecomastia is the benign enlargement of male breast tissue (>2 cm palpable, firm, subareolar gland and ductal tissue) due to a relative drop in changes due to the influence of androgens or rise in the effects under the influence of estrogen. Pseudogynaecomastia on the other hand is enlargement of the breast due to deposition of excess adipose tissue. This disease is caused by multiple factors like Physiological factors, endocrine and non-endocrine factors, drug induced and idiopathic. This is a prospective observational study of 20 cases of male patients with enlarged breasts presented during the period between September 2018 to August 2020.Patients with enlarged breasts satisfying the inclusion criteria, attending Surgery OPD. The evaluation of gynaecomastia is a tricky process. A serial approach that begins with meticulous history taking and physical examination may eliminate the need for a cumbersome work- up. Appropriate clinical workup with appropriate investigations to confirm gynaecomastia and rule out malignancy is essential. The etiology is usually benign and treated conservatively or surgically depending on the grade of gynaecomastia. Pseudogynaecomastia is due to fat accumulation in the breast area, causing “female-like breasts”. This condition is most often present in overweight or obese males. The treatment ranges from weight loss via diet and exercise, to weight loss bypass procedures or male breast reduction surgery.