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Our definition of ovarian cyst was a unilocular cyst with anechoic cyst contents \u2265\u200935\u2009mm in mean diameter, or any other type of intraovarian lesion. The prevalence of extrauterine pelvic lesions was compared between women not using hormonal contraception and those using <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content> or a gestagen <jats:styled-content style=\"fixed-case\">IUD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ovarian lesions were found in 24 (3.7%) women. One woman had bilateral ovarian lesions. An ultrasound diagnosis of paraovarian cyst was made in 41 (6.4%) women, of peritoneal cyst in four (0.6%) women and of hydrosalpinx in one (0.2%) woman. All incidentally detected lesions had a mean diameter of \u2264\u20095\u2009cm. One 17\u2010mm intraovarian lesion was suspicious for malignancy, and histology confirmed a Sertoli\u2013Leydig cell tumor. The ultrasound diagnoses in the remaining 23 women were endometrioma (<jats:italic>n<\/jats:italic>\u2009=\u200910 (1.6%)), dermoid cyst (<jats:italic>n<\/jats:italic>\u2009=\u20095 (0.8%)), cystadenofibroma (<jats:italic>n<\/jats:italic>\u2009=\u20091 (0.2%)), mature teratoma (<jats:italic>n<\/jats:italic>\u2009=\u20091 (0.2%)) and functional cyst, i.e. a cyst that resolved within 3\u20135 months (<jats:italic>n<\/jats:italic>\u2009=\u20096 (0.9%)). Four women with an ultrasound diagnosis of a benign lesion were operated on, and the ultrasound diagnoses of endometrioma (<jats:italic>n<\/jats:italic>\u2009=\u20092), dermoid cyst (<jats:italic>n<\/jats:italic>\u2009=\u20091) and mature teratoma (<jats:italic>n<\/jats:italic>\u2009=\u20091) were confirmed histologically. The prevalence of persisting ovarian lesions was highest in women with spontaneous menstrual cycles (4.4% <jats:italic>vs<\/jats:italic> 0.9% and 0% in women using <jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content> and gestagen <jats:styled-content style=\"fixed-case\">IUD<\/jats:styled-content>, respectively; <jats:italic>P<\/jats:italic>\u2009=\u20090.025), but age was the only factor independently associated with persisting ovarian masses, the prevalence increasing with age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Benign ovarian lesions are found in about 1 in 25 gynecologically asymptomatic women aged 20\u201339 years with no history of gynecological disease. To be able to offer optimal management of such masses, their natural history needs to be elucidated in a large prospective observational study. Copyright \u00a9 2013 ISUOG. 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