The superior soft tissue contrast of MRI aids characterisation of adnexal masses. T2-W contrast is the mainstay of diagnosis. Enhancement of T1-W images with gadolinium chelate is helpful in refining diagnosis. Examinations are optimized by scanning after the patient has emptied her bladder and intramuscular antiperistaltic agents have been administered. Classification into benign and malignant pathology is crucial for deciding on type of surgical management. In addition, recognition of disseminated malignant disease determines whether or not neoadjuvant chemotherapy is warranted prior to surgical debulking.