Post-transplant sonograms in female recipients sometimes reveales unsuspected adnexal masses. Sonographically, these masses are difficult to distinguish from other post-transplant fluid collections, such as lymphoceles, urinomas or abscesses and, consequently, further diagnostic evaluations such as transvaginal sonography is required. We had ten female kidney transplant patients with complain of adnexal mass. On further follow up four of them proved to be lymphocele, three resolved by contraceptive pill, 3 were excised surgically: 1 was hemorrhagic ovarian cysts, 1 was a follicular ovarian cyst and 1 was a paraovarian cyst. Laparoscopic surgery provides better evaluation and ideal surgical treatment. A coexisting gynecologic mass should be included in the differential diagnosis of a perinephric mass in female transplant recipients. Pre-transplant sonograms to identify or exclude occult pelvic masses in women may be of benefit in simplifying the postoperative management and minimizing unnecessary diagnostic evaluation. Video of one of these patients who had laparoscopic surgery is ready to present.