Ovarian cysts and tumours are a relatively common finding among women of many ages, particularly with the wider use of regular physical examinations and ultrasound. Most cysts and tumours in younger women are not malignant and can often be managed entirely within primary care. However, malignant tumours also occur. The average GP will see a new case of ovarian cancer every 4 to 5 years. Ovarian cancer is the second most common cancer of the female genital tract and the leading cause of death due to gynaecological malignancy. Ovarian cancer is frequently diagnosed at a late stage and carries a poor prognosis. Guidance published by the National Institute for Health and Clinical Excellence (NICE) in 2011 recognises this fact and recommends changes to the way in which cases are detected and managed in primary care. This article is a revision of a previous InnovAiT publication, incorporating recent changes to recommended practice.