The aim of this study was to evaluate the pathological features and pregnancy outcomes of pregnancy-associated adnexal masses, between 2001 and 2007. During this period, 0.3% of deliveries (35) were associated with adnexal masses. Torsion or rupture of the adnexal mass complicated pregnancy in 17.1% (6/35) of the cases. The most common histopathological diagnosis was dermoid cyst in 40% of cases (14/35), and 8.5% of cases (3/35) were malignant, including borderline ovarian lesion. None of the patients had an adverse pregnancy outcome due to emergency laparotomy. Pregnancy-associated persistent adnexal masses with large size, complex or solid appearance and bilateral location can be managed surgically, which can decrease the risk of complications, such as torsion or rupture and which can diagnose malignancies early.