Adnexal masses are one of the most common pathologies among women of all age groups. Ovarian tumors, alone, represent two thirds of these cases. Malignant ovarian tumors are the fourth most common cause of death in women. Accurate diagnosis is required foremost for proper treatment and management of the patients.Methods: A prospective study done on 100 patients with adnexal masses presenting to Department of Obstetrics and Gynecology at Kamla Raja Hospital, G.R.M.C, Gwalior from February 2015

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... August 2016. Firstly, the cases were studied by ultrasonography then intraoperatively and simultaneous sampling for HPE done. The study included women with clinical symptoms of pain abdomen/ discomfort, bleeding per vaginum, abdominal mass was subjected to ultrasonography, diagnosed with adnexal mass. 100 indicated patients were taken for surgery and intraoperative tissue and fluid samples were taken and sent for HPE.Results: No discordance found regarding laterality of adnexal masses between ultrasonographical findings and surgical findings. 69% cases were devoid of any septation/locules/nodules. Most common pathology found to be ectopic pregnancy. Most common benign ovarian mass encountered was serous cystadenoma (31.1%) and malignant mass was serous adenocarcinoma (12.7%). Apart from 13 malignant adnexal masses, 2 adnexal masses had malignant changes found on histopathological examination. 11 cases were found to be of advanced stage on surgical findings, which then confirmed by HPE.Conclusions: There is positive correlation between ultrasonographical and surgerical evaluation of adnexal masses. Correlation of the lesion's location and appearance at imaging with the surgical findings will aid in the detection of potential pathology reporting errors.