The size of the mass in three dimensions, its location, consistency, and borders (well-/ill-defined) should be determined for a diagnostic approach to masses. Generally, most diagnoses can be made by transvaginal ultrasonography; however, a combination of transabdominal and transvaginal scan should be considered as they have different advantages and disadvantages. Follicular ovarian cysts comprise the most common cystic adnexal mass seen in women of reproductive age. Luteal cysts are characterized by peripheral blood flow at Doppler examination and menstrual disturbances. Recently three-dimensional (3D) or volume ultrasonography has been added to the gynecologic assessment armamentarium. The availability of noninvasive ultrasonography has resulted in improved care for infertile women. The ability to diagnose and decide on appropriate treatment is invaluable in helping women to achieve better fertility outcomes where identified pathology is detrimental, but also in improving patient well-being where this may be more serious, such as malignancy, and is dealt quickly.