A 22-year-old gravida 1, para 0 woman with a left hemorrhagic ovarian cyst. Prepregnancy transvaginal ultrasound shows a 5 cm well-defined left-sided complex adnexal mass with thick walls, regular margins of mixed solid and cystic components with low-level internal echoes. No internal septations and no ascites was noted. A normal appearing left ovary is not seen separate from this mass. Diagnosis of hemorrhagic ovarian cyst was initially made.