Ovarian masses larger than 100 pounds are rarely encountered in developed countries given advancements in early diagnosis and treatment. Their successful resections pose unique surgical and anesthetic challenges. An otherwise healthy 38-year-old para 1 woman developed a 50 × 60 cm pelvic mass. An exploratory laparotomy, left salpingo-oophorectomy and anterior abdominal wall reconstruction were performed. A total of 60 L of cystic fluid were drained. Close monitoring of hemodynamics and massive volume resuscitation required intensive care. Inpatient physical rehabilitation reinstated independent mobility. Final pathology revealed benign ovarian mucinous cystadenoma. A multidisciplinary approach in the preoperative, intraoperative and postoperative stages of management optimizes patient outcomes.