Background: Adnexal mass is one of the most common gynecologic diseases among women of all ages. Methods: In this cross-sectional study, we enrolled 126 patients with large adnexal masses (≥ 10 cm) managed by laparoscopic surgery during 2013 - 2020. The rates of intraoperative complications, conversion to open surgery, and incidence of cancer were assessed. Results: Mean mass size was 15.08 ± 5.03 in all participants without significant difference based on the tumor type (P = 0.624). Mean age and operation time were higher in the malignant type compared to the benign type (P < 0.001). Type of surgery and frequency of intraoperative complications were also different among patients with different tumor types (P < 0.001 and P = 0.816, respectively). Conclusions: Our study showed that large adnexal tumors can be operated by laparoscopic approach, while the most important factor for increased surgical complications and duration was malignancy.