ABSTRACT Background: Different tools have been used for prediction of malignancy in ovarian masses; such as tumor markers, ultrasound findings, or other malignancy indices combining more than one variable. Cancer antigen 125 (CA-125) is the most frequently used biomarker for ovarian cancer detection. Objective: To investigate whether laparoscopy could replace safe and effective surgical management of adnexal masses. Patients and Methods: This was a prospective study. It was conducted over 2 years in Al-Maadi Military Hospital and Air force General Hospital. The study was conducted on 100 patients from October 2018 till September 2020. Histopathology was done by Histopathology team at Maadi Military hospital. Results: All 93 patients managed laparoscopically had a benign and malignant diagnosis, whereas 7 of the 19 patients who underwent laparotomy were diagnosed with malignancy. The indications for conversion to laparotomy were malignancies, dense adhesions and small bowel enterotomies. Conclusion: Laparoscopic surgery seemed to offer significant advantages such as reduced hospital stay, less adverse effects, and better quality of life, laparoscopic surgery became a corner stone in management of adenexal masses either benign or malignant especially if the facility of Frozen Section Biopsy can be offered.