The occurrence of ovarian cysts in a neonate is common, but the management of the same is contentious. We present a case of a prenatally diagnosed complex ovarian cyst in a neonate, which was successfully treated by a novel laparoscopic technique. The literature was reviewed and the diagnosis, treatment options, and controversies in the management are discussed, highlighting the role of preservation of the ovary via the laparoscopic-assisted transumbilical ovarian cystectomy procedure.