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INTRODUCTION: Ovarian cysts can develop at any age; however, they are more common during the reproductive years. In general, in the younger population, the goal of management is conservative, with observation and resolution of symptoms, prevention of complications, and, when necessary, proper treatment of malignant tumors while maintaining ovarian structure and function. We report a case of giant mucinous cystadenoma in a late adolescent girl. CASE REPORT: A 20-year-old adolescent girl presented to the gynecology outpatient department with gradual distension of the abdomen for 6 months. There were no other associated gastrointestinal or urological symptoms. Her menstrual cycles were regular, general examination was fair, and abdominal examination revealed a cystic mass of size 36 weeks (30 cm*26 cm) occupying all the quadrants of the abdomen. A CT scan showed a well-defined, nonenhancing hypodense cystic lesion (32*21*13 cm) in the right adnexa. HE4 with ROMA index value done was low risk for epithelial ovarian cancer. Right salpingoopherectomy was done with preservation of the left adnexa. Histopathological examination results confirmed giant mucinous cystadenoma of weight 5.5 kg. DISCUSSION: We hereby report the case of a 20-year-old woman who presented with a huge ovarian cyst. The patient in our case didn?t seek medical attention for 6 months until she noticed unusual distension of the abdomen with associated shortness of breath. To estimate the risk of malignancy, ultrasound features without CA-125 levels have been shown to have high sensitivity, specificity, and likelihood ratios. Malignant ovarian cysts account for over 10% of all gigantic ovarian cysts. Laparoscopically, in giant ovarian cysts, especially those that reach the umbilicus, there is a risk of perforation when the trocar is inserted. In this case report, open salpingo-oophorectomy was done without any perioperative complications.