Chronic kidney disease (CKD) is a major global health problem associated with significant morbidity, mortality, and healthcare expenditure. Renal biopsy remains the gold standard for diagnosing the underlying etiology of CKD, determining disease severity, assessing prognosis, and guiding therapeutic decisions. Histopathological examination using light microscopy, immunofluorescence, and electron microscopy enables accurate characterization of glomerular, tubulointerstitial, and vascular lesions. The spectrum of biopsy findings varies according to geographic region, age, ethnicity, and indications for biopsy. Common diagnoses include IgA nephropathy, focal segmental glomerulosclerosis (FSGS), membranous nephropathy, diabetic nephropathy, lupus nephritis, minimal change disease, amyloidosis, and chronic tubulointerstitial nephritis. This review summarizes the clinicopathological spectrum of renal biopsy findings in CKD, highlights diagnostic approaches, and discusses recent advances in digital pathology and molecular nephropathology.