Adnexal masses are considered common gynaecologic clinical problems. Most lesions are benign necessitating conservative management and follow-up. Ovarian cancer is considered the most lethal gynaecological cancer in women. Annually, it is responsible for an estimated 152,000 deaths, and 239,000 new cases are recorded worldwide. In Egypt, it accounts for 4.1% of all cancers affecting women, considering it one of the most common diagnosed cancers among the Egyptian females [. Typic- ally, ovarian cancer presents at late stage when its 5-year survival rate is less than 30%. GI-RADS classification system for adnexal masses, in which GI-RADS 1 was considered definitely benign, GI-RADS 2 very probably benign, GI-RADS 3 probably benign, GI-RADS 4 probably malignant, and GI-RADS 5 very probably malignant. Findings suggestive of malignancy included thick pap- illary projections, thick septa, solid areas with/without ascites and vascularization within solid areas, papillary projections or central area of a solid tumour on colour or power Doppler assessment as defined according to the International Ovarian Tumour Analysis criteria(IOTA).