Background:The adnexal masses represent a variety of diseases, ranging from normal luteal cysts to ovarian cancer, from gynecological or non-gynecological origins. Transvaginal sonography (TVS) has turned into the first step imaging method for describing adnexal masses. Transvaginal ultrasonography is the initial method for detection of adnexal masses, it can visualize the deeper structures and even note the fine details of the organs like fallopian tube and ovary, also distinguish between benign and malignant lesions. Gynecologic Imaging Reporting and Data System (GI-RADS): is a new system based on BI-RADS for reporting findings in adnexal masses identified by TVS. Thick papillary projections, thick septa, solid areas with/without ascites, defined according to the International Ovarian Tumor Analysis criteria and vascularization within solid areas, papillary projections or central area of a solid tumor on Color or Power Doppler assessment are suggestive signs of malignancy.