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, morphological scoring systems can help in accurately predicting the nature of the mass with the help of pulsed wave Doppler and ultrasonography.This study includedthirtyfivepatientswith43adnexalmasses.Alcazar morphological scoring system was applied to these masses. Masses scored (0-5) were claimed to be low risk and (6-12) were claimed to be high risk for malignancy . The final histopathology result of these masses was compared with the provisional Alcazar score .The role of this scoring system was evaluated in the assessment of adnexal masses. It was found that this scoring system had the highest sensitivity, positive predictive value and highest diagnostic accuracy in comparison to Ca-125, Risk of malignancy index, Doppler and ultrasound parameters alone.