Purpose: To analyze laparoscopic findings of adnexal masses and correlate them with clinical examination and ultrasound findings. Study design: Retrospective observational study. Setting: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India. Sample size: A total of 137 subjects. Duration of study: From May 2012 to April 2013. Inclusion criteria: All women admitted with clinical suspicion of adnexal masses. Exclusion criteria: Women with suspicion of malignant ovarian masses. Materials and methods: This is a retrospective observational study carried out in the Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India during the period from May 2012 to April 2013. A total of 137 patients who underwent laparoscopy for suspected adnexal masses were included in this study. Case records of these patients were retrospectively analyzed, and detailed clinical examination and ultrasound findings done were noted. These findings were correlated with laparoscopic findings. Results: In the study group, 98.3% of cases of endometriosis clinically correlated with laparoscopic findings whereas ultrasound correlated with only 93.7% of endometriosis. Similar correlations were observed in benign ovarian masses on clinical examination and ultrasound, 89.3 and 96.4%, respectively. Similarly, ectopic pregnancies diagnosed by clinical examination correlated with laparoscopy in 93.8% of cases whereas ultrasound findings correlated only in 90.6% of cases. All the cases of paraovarian cysts were missed in clinical examination, whereas ultrasound detected 20% of cases. In suspected cases of pelvic inflammatory disease, ultrasound diagnosed hydrosalpinx in 66.7%, whereas clinical examination failed to diagnose. Ectopic pregnancy was either missed or not suspected when patients presented with acute abdomen to another specialty (Department of Surgery). Conclusion: Laparoscopic findings correlated with clinical examination and ultrasound in endometriosis, ectopic, and ovarian masses. Paraovarian cysts were either not suspected or misdiagnosed as ovarian cysts during clinical examination whereas ultrasound diagnosed one-fifth of cases. Take-home message: Laparoscopy is useful when simultaneous therapy can be offered, not as a diagnostic tool alone.