Background: Adnexal masses represent a diagnostic dilemma. They can be encountered in females at any age. Imaging has essential role in their diagnosis and subsequent management. Ultrasonography (USG) is the initial imaging study of choice in the evaluation of adnexal lesions. USG and magnetic resonance imaging (MRI) are best in the assessment of adnexal mass lesions. Aim: To determine the role of endosonography and conventional MRI for assessment and differentiation of various adnexal lesions in childbearing period females. Subjects and Methods: We prospectively studied 50 women in childbearing period (age from 15 to 50 years) with adnexal lesions either symptomatic or accidently diagnosed. All patients were subjected to ultrasound (both transabdominal and transvaginal ultrasonography (TVUS) and MRI examination. The agreement between these modalities final diagnosis was calculated. The sensitivity and specificity of these modalities to correctly distinguish benign and malignant pathologies were calculated. Result: Most commonly affected age group was 26-35 years. The major presenting complaints were lower abdominal pain and lump in the lower abdomen. In our study, most common origin of adnexal lesions was from ovaries. MRI has sensitivity of 100% and specificity of 97.9 % while USG has sensitivity of 80% and specificity of 95.1% in diagnosis of adnexal lesions. Conclusion: Conventional MRI is superior to ultrasound in identification and characterization of adnexal masses. Combined endosonography and conventional MRI are sufficient for accurate diagnosis of most adnexal lesions in females in childbearing period. This will definitely obviate further costly functional MRI, also unnecessary gynaecological interventions and surgeries, and subsequently preserve fertility in such age group.