The early diagnosis of ovarian tumors is hindered by the inaccessibility of the ovary by noninvasive techniques. The increasing popularity of fine needle biopsy and laparoscopy created a demand for using these techniques to diagnose ovarian masses. Ovarian masses were aspirated prior to, during, or after laparotomy and laparoscopy. The cases included a variety of nonneoplastic cysts and benign and malignant neoplasms. The nuclear and cytoplasmic features of the aspirated cells, the background material and the presence of other structures such as hair, and psammoma bodies and hyaline bodies made it possible to classify most tumors regarding their behaviors as well as their specific type. Malignant neoplasms in general produced more cellular specimens than benign tumors. It was difficult to differentiate between some types of sex cord/stroma neoplasms. Aspiration cytology, which can be performed through a laparoscope transvaginally, transrectally, or transabdominally is a safe, noninvasive, and relatively reliable technique. It should be utilized more in evaluating ovarian masses, when it is desirable to preserve ovarian function in young patients or to minimize surgical trauma to the elderly high-risk patients.