Ovarian cysts are fluid-filled sacs of the ovary and are found in women of all ages. Some cysts can cause pain or pressure, while others cause no symptoms and are found on exam or sonogram. Fortunately, most ovarian cysts do not require intervention or surgery, and are not a sign of cancer. Whether or not a woman with an ovarian cyst needs surgery depends on her age, symptoms, and the type of cyst she has or is though to have. The different types of cysts are functional cysts (a growing follicle that has not released an egg), dermoid cysts (containing teeth, hair, or fat), endometriomas (“chocolate cysts” in a woman with endometriosis), cysts seen in pregnancy, multiple small cysts in a patient with PCOS, and ovarian cancer. Ovarian cysts can rupture and cause sudden pain. Ruptured cysts sometimes bleed heavily and require emergency surgery. Some cysts, especially dermoid cysts, can cause twisting of the ovary, leading to severe pain. A twisted ovary, called ovarian torsion, can block the flow of blood to the ovary and lead to ovarian death, so this event also requires surgery to untwist the ovary and remove the cyst. In our office, we perform ovarian cyst surgery laparoscopically and as outpatient surgical procedures.