The purpose of this retrospective study was to determine the frequency, clinical aspects and surgical management of ovarian masses in 52 adolescent patients, in whom surgery was deemed necessary, from 1991-2006. We considered age, symptoms, ultrasound investigations, CA 125 levels, family history, operative treatment, surgical complications tumor size, histopathological examinations, pregnancy rate and follow-up. Ovarian lesions in teenagers include a broad array of pathologic diagnoses that have variable and non-specific presenting symptoms. The most common presenting complaint was abdominal pain in 34 (65.4%). Forty-seven patients (90.4%) had benign lesions, two (3.8%) had borderline tumors and three patients had malignant lesions (5.8%). Most of the patients who wanted to conceive subsequently did so. For benign ovarian disorders the operation should be designed to optimize future fertility while in patients with malignancy, complete staging and resection of the lesion should be the first concern.