Adnexal masses are considered a group of the most common diseases in gynecology. Ovarian tumors, alone, represent two thirds of these cases. 2D ultrasound & CA 125 separately were the main diagnostic tools in provisional diagnosis of these adnexal masses. Now, pulsed wave Doppler, three dimensional power Doppler angiography and risk of malignancy index application can help in the assessment of adnexal masses. This study included thirty patients with complex adnexal masses, the role of these tools was evaluated in the assessment of their lesions. It was found that, clinical picture alone has the lowest sensitivity to predict malignancy while applying these tools can improve the assessment of adnexal masses and provisionally differentiate between benign and malignant ovarian tumors.