The Royal College of Obstetricians and Gynaecologists currently publish guidelines for the management of ovarian cysts in both pre- and post-menopausal women. The presence of an ovarian cyst can come to light during pregnancy either because of symptoms or as an incidental finding during routine ultrasonography. Ovarian cysts are common in pregnancy and are usually small and of no clinical significance. While the guidelines do not specifically include pregnant women, care in pregnancy is largely the same as outside pregnancy in that it is individualised depending on clinical presentation and whether ultrasound scans identify concerning features requiring further investigation or intervention. Where appropriate, surgical intervention occurs after delivery of the baby, although can occur during pregnancy when urgent. Optimal care is provided by multidisciplinary teams involving gynaecology, radiology, obstetric and midwifery input.