Massive ovarian oedema is a rare non neoplastic condition presenting with solid ovarian enlargement affecting young women. The lack of pathognomic clinical features, specific radiological findings and hormonal tests makes this entity challenging for a clinician as it can easily be mistaken for neoplasm. The erroneous diagnosis, may results in overtreatment in young patients with resultant loss of hormonal function and fertility. A 14 year young girl, who attended menarche, presented with acute abdominal pain of short duration. Clinical and radiological findings were suspicious of ovarian neoplasm. Due to acute presentation, she underwent emergency salphingo–oophorectomy. To our surprise the gross and histomorphology favoured a diagnosis altogether of a benign lesion of massive ovarian oedema. The case reinforces awareness about this rare condition and intra operative frozen section study if available; together can help to plan precise surgery and can prevent unnecessary overtreatment particularly in young girls.