Ovarian immature teratoma (IT) is uncommon after the first two decades of life. Management is largely surgical, and recurrences are rare. Ovarian IT has the potential to convert into mature disease at the time of recurrence. The current case report describes a 47-year-old female patient who developed two recurrences within three years. The primary disease and first recurrence were managed surgically, whereas the second recurrence was managed surgically plus adjuvant chemotherapy with bleomycin, etoposide and cisplatin (BEP) regimen. Histopathology was immature teratoma grade 3 initially which progressed to immature teratoma grade 1 in last recurrence. Alpha-feto protein levels were never raised except two months after the last laparotomy when the patient was diagnosed to have hepatic metastases and succumbed to disease. Prognosis was grave in our patient. Advanced age may be a one contributing factor. Relapse of ovarian IT is uncommon and its optimal management remains debatable.
