This was a retrospective study for the years 1979 to 1989 involving histological examination of ovarian cysts in women over 50 years who underwent surgery in our Department. A higher incidence of malignant tumours was found (32%), associated with a late diagnosis (70%) diagnosed stage III or IV). There was a higher incidence of fibrothecomas (10%) among benign tumours and functional cysts were only found in non menopausal or recently menopausal women taking hormone replacement therapy. There results allow a more specific therapeutic attitude in menopausal women i.e. laparoscopic surgery or laparotomy. Ultrasound puncture is very debatable, since this is inappropriate for an organic cyst. The authors review the complementary investigations performed for ovarian cyst, these include essentially ultrasound and Ca 125. Possible therapies include transparietal cystectomy, intraperitoneal cystectomy or laparotomy and excision.