A correct handling of OPHL surgical specimens in all the phases, starting from orientation and grossing, is pivotal for a correct histological diagnosis, since it is based on the recognition of important anatomical structures both macroscopically and microscopically. Clinical and radiological data have to be known and have to guide the approach in the grossing phase (e.g., sagittal vs coronal). A careful balance must be achieved during decalcification, in order to reduce cutting artifacts and preserve the composition of soft tissues. Being a conservative technique, the margins in OPHL specimens can be very close and must be sampled carefully. A short guide to recognize anatomical landmarks under the microscope is also provided.