Genital neoplasms in men and women are much rarer than neoplasms located elsewhere on the body and can be subdivided into lesions that are benign, premalignant, or malignant. For females, this chapter discusses the sex-specific malignant and premalignant lesions such as vulvar intraepithelial neoplasias, Bartholin gland carcinomas, and adenocarcinomas. In males, many malignancies are shared with those of females such as melanoma, basal cell carcinoma, and squamous cell carcinomas. Additionally, benign lesions in women are explored, specifically vulvar cysts, hidradenoma papilliferum, vulvar papillomatosis, leiomyomas, lipomas, and angiomyxomas. In men, the benign lesions discussed are sebaceous hyperplasias which have a higher prevalence in males, pearly penile papules, and scrotal steatocystomas. Lastly, this chapter discusses lesions present in both men and women, such as angiokeratomas of Fordyce, basal cell carcinoma, squamous cell carcinoma, melanoma, and hyperpigmented lesions. By providing detailed information on prevalence, presentation, histopathology, and treatment, this chapter provides a comprehensive understanding of genital neoplasms and can help facilitate accurate diagnosis and management of these rare lesions.