Objective:To evaluate types of pelvic masses in women with inflammatory bowel disease (IBD), and to compare preoperative evaluation with histopathological findings during surgery.Materials and Methods:Demographic and clinical data of 150 women admitted to the Cleveland Clinic Foundation (Cleveland, OH) between 1985 and 1996 with diagnoses of IBD (Crohn's disease and ulcerative colitis) and pelvic, ovarian, or adnexal masses, cysts, or tumors were analyzed.Results:The study included 150 women with a mean age of 38 years. Twenty‐three women (15%) had symptomatic pelvic masses, 5 (22%) of which were malignant (2 primary ovarian cancers, 3 metastatic intestinal cancers). One hundred twenty‐seven women (85%) had masses that were discovered during routine examination, radiologic studies, or IBD surgery; most were functional cysts or pseudocysts (94 of 127, 74%), and only 2 were malignant.Conclusion:Women with IBD who develop new symptoms related to a pelvic mass are at high risk for malignancy.