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Introduction: Adnexal masses are a common diagnosis in Gynaecology out-patient department. It can be benign or malignant. To arrive on a diagnosis, patient should be subjected to clinical examination and a variety of investigations. Management is tailored according to the diagnosis, age of the patient and the reproductive goal of the patient in future. Aim: To evaluate the proportion of benign and malignant aetiology in patients presented with adnexal mass and secondarily to correlate preoperative diagnosis with the histopathological diagnosis. Materials and Methods: A prospective observational study was conducted, where patients with adnexal masse presented during one year were included. After work-up for all the patients, appropriate case based management was done. Clinical diagnosis of benign or malignant as pre-operative was co-related with histo-pathology and proportion of benign and malignant cases were noted. Results: Total 81 cases with the diagnosis of adnexal mass were included in the study. Mean age of presentation was 36.26 years. Most common presentation was pain in abdomen; 70 (86.4%) patients had benign masses, while 11 (13.6%) masses were malignant including two cases of borderline variety. Both patients underwent exploratory laparotomy with peritoneal lavage with total abdominal hysterectomy with bilateral salpingo-oophorectomy with infracolicomentectomy. Conclusion: All Adnexal masses need to be evaluated clinically and radiologically. All investigations should aim at to differentiate benign and malignant masses. Preoperative diagnosis of benign or malignant mass is very important to plan optimum management of the case. [ABSTRACT FROM AUTHOR]