Background: Ultrasonography (USG) is accepted as the primary imaging modality in the evaluation of adnexal pathologies and provides useful information regarding the nature of the lesion and to plan for appropriate intervention. The current study was planned to evaluate the diagnostic utility of USG and DOPPLER in differentiating different adnexal Masses (benign or malignant) and comparing them with histopathological findings. Materials and Methods: A total of 70 patients referred from various departments were included in the study. B-mode sonomorphological criteria were used and subsequently spectral Doppler tracings were recorded by calculating resistive index (RI) and pulsatility index (PI) values. Modified International ovarian tumor analysis (IOTA) Scoring system, RI and PI value was applied to differentiate benign and malignant pelvic masses. Results: On final diagnosis, the malignancy rate was 2.9% (n=2). As compared to histopathology, Doppler/USG was 100% sensitive and 96.3% specific. It had a positive predictive value of 96.3% and negative predictive value of 100%. The diagnostic accuracy was 96.6%. Conclusion: The findings of this study showed that USG/Doppler evaluation is very useful in evaluation of adnexal masses and their management. Use of USG/Doppler in the initial evaluation helps to reduce the need for surgical intervention and successful detection of malignancy.