Due to recent epidemiological studies on ovarian cysts during pregnancy, incidence of ovarian tumors in pregnant women is estimated on 1/1000 deliveries and the majority of cases are benign on histological examination . Most adnexal masses are physiological, asymptomatic and spontaneously resolve before the 16th week of amenorrhoea. On the other hand, some cases are persistent forms which can cause complications for the mother and fetus which may result in serious maternal and fetal complications and the management is still controversial. Problems due to the association of the ovarian cyst and pregnancy are especially of diagnostic and therapeutic order. We present a case in which the rarity is given by the association of a huge 16cm anechoic right ovarian cyst and abdominal pain with 29 gestation week pregnancy. Conservative management of simple adnexal cysts in pregnancy, based on their sonographic appearance, can avoid risks of abdominal surgery in the second trimester of pregnancy, but in the third trimester, a large cyst can create significant complications requiring surgical intervention.
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