Objective: The purpose of this case is to describe findings of a mature cystic teratoma and to further provide differential diagnoses for ovarian pelvic masses and calcifications. Clinical Features: A 27-year-old woman presented to a chiropractic teaching clinic with a chief complaint of chronic multilevel spinal pain. During a full spine radiographic examination, radiopaque densities were incidentally identified in the pelvic bowl visualized through a gonad shield. Follow-up pelvic radiography revealed several radiopacities of uniform density localized in the pelvic bowl. Intervention/Outcomes: Medical (gynecological) consultation led to ultrasonography of the pelvis that revealed a mature cystic teratoma. The patient underwent complete excision of the mass through a laparotomy procedure. The patient continued to receive chiropractic treatment of her original cervical and lumbar spine complaints, further suggesting that the pelvic mass was not a source of her musculoskeletal complaints. Conclusion: This case demonstrates the detection and proper referral of a patient with a calcific mass. The presence of a pelvic mass, suspected of arising from the ovary, requires additional diagnostic imaging and careful clinical correlation.