The management of certain ovarian cysts has evolved from the traditional and often quite radical surgical approach to a more conservative approach. Much of this change can be attributed to the improvement in laparoscopic surgical technique. After a brief discussion of the differential diagnosis and clinical presentation of ovarian cysts, ultrasonographic features of certain ovarian cysts will be reviewed. Certainly the ability to characterize cysts ultrasonographically has facilitated gynecologists' ability to predict the neoplastic potential of a cyst and therefore to justify the more conservative approach. The various techniques of laparoscopic ovarian cyst aspiration, fenestration, and cystectomy will then be described.