Transvaginal ultrasound examination is an excellent tool for solving clinical problems in women with symptoms suggesting the presence of adnexal mass. An experienced ultrasound examiner can confidently discriminate between benign and malignant pelvic tumours in the adnexal region using pattern recognition. Some tumours - for example, endometriomas, dermoid cysts, hydropyo- and haematosalpinx, peritoneal pseudocysts, paraovarian cysts, haemorrhagic corpus luteum cysts, myomas, abscesses and ovarian fibromas, thecomas and Brenner tumours - may present with typical appearances at greyscale imaging. Doppler assessment of intratumoral blood flow contributes little to the correct specific diagnosis of adnexal mass. The ability to make a correct specific diagnosis in a series of pelvic tumours is highly dependent upon the types of tumour in the tumour series studied. The surgical removal of the adnexal mass with benign ultrasound morphology is incidentally detected at ultrasound examination in asymptomatic women.