Introduction: An adnexal mass is a common gynecological problem, diagnosis of which is based on clinical presentation, various radiological imaging and biomarkers. To evaluate adnexal masses in context of clinical, radiological and pathological diagnosis. Methods: A total of 100 consecutive patients presenting in our hospital with adnexal mass were selected for the study matching the inclusion and the exclusion criteria. A detailed history of each case was recorded with special attention to the presenting complain and a detailed examination was performed. Cases were investigated by radioimaging and serum biomarkers. Various adnexal masses were studied with respect to the manifestations and radiological and biochemical findings. Results: Most common presenting complaint was pain (68%) followed by no complains (15%) and abdominal distention (7%). Other symptoms include lump in abdomen, nausea and vomiting. Most of the adnexal pathologies were unilateral (83%) on presentation with 47% involving left side. Most common pathology identified in the left adnexa was ovarian cyst, followed by ectopic pregnancy. Most common benign pathology diagnosed as per sonography was ovarian cyst (40%). Conclusions: Ultrasonography is an important noninvasive investigation helpful in diagnosing most cases of adnexal masses. Bimanual palpation can be useful as a first step in assessment of adnexal masses. However no single diagnostic aid can be used to determine the pathological adnexal masses. Hence a multifaceted diagnostic approach should be used for a definite diagnosis and management of adnexal mass.