Adnexal masses are considered a group of the most common diseases in gynecology and ovarian tumors represent two thirds of these cases. 2D ultrasound has become the main diagnostic tool in Obstetrics and Gynecology. 3D ultrasound, color Doppler in addition to serum level of CA125 can help in the assessment of adnexal masses. This study included sixty patients with adnexal masses and the role of the previous tools was studied in the assessment of these lesions. It was found that, clinical picture has the lowest sensitivity to predict malignancy. There’s no great difference between 2D and 3D ultrasound assessment however combination of both is better than either alone. Doppler studies and serum level of CA125 can improve the assessment of adnexal masses and differentiation between benign and malignant ovarian tumors.