Background: Adnexal mass lesions are very common among women of all age group but very common among reproductive age. Differential diagnosis of adnexal mass is difficult and complex. Recognition of the severity of the problem, appropriate and timely evaluation and treatment with good outcome is the goal. Ultrasound is the primary modality used for detection and characterization of adnexal masses. The purpose of this study is to evaluate the diagnostic accuracy of ultrasonography in patients suspected with adnexal masses. Objectives: Understanding the characterization of adnexal masses on ultrasonography and colour doppler,and to corelate the usg findings with histopathology where ever possible,to derive simple and clinically useful usg based IOTA rules for discriminating between benign and malignant mass. Methods: The study was conducted on 100 patients with suspected various adnexal masses in a period of 1 year from 2018-2019. Patients are selected based on Clinical history & Adnexal masses detected on pelvic ultrasound. Results of ultrasound were correlated with available histopathological findings. Results: On histopathology, out of total 50 cases studied 14(28%) were malignant and 36 (72%) were benign. Out of 45 cases where IOTA simple rules were applicable, 16(35.5%) were malignant and 29(64.4%) were benign. Conclusion: On comparing the findings of ultrasonogram versus histopathology, it was found that ultrasound had a high sensitivity of 91.66%, 84.84% specificity, 68.7% positive predictive value, 96.55% negative predictive value and 88.8% accuracy of detecting adnexal masses. Keywords: TAS – Transabdominal sonography, TVS – Transvaginal Sonography, Adnexal Masses.