Aim <p>To study and compare the number, size, location, and character of adnexal lesions identified by CEUS and MRI and correlate the results with gross intra-operative and histopathological findings.</p> Background <p>CEUS is a newly emerging diagnostic modality. It involves the administration of intravenous contrast agents consisting of microbubbles. The distinguished acoustic properties of the gas in the microbubble enable it to produce high-frequency harmonics that enhance the ultrasound images. CEUS provides the ability to detect intralesional microvascularity. It can produce real time imaging and thus can be used during interventional procedures.</p> Methods <p>It was a prospective observational study with a sample size of 150 study subjects. The contrast agent used in our study is commercially&#xa0;known as Sonovue, which is made of Sulphur hexafluoride microbubbles.</p> Results <p>150 cases of adnexal masses were studied. There was no significant difference between CEUS and MRI reports with respect to the size of the lesions as shown by a t-test (t = 0.06, <i>p</i> = 0.53) and Pearson correlation coefficient (r = 0.96, <i>p</i> = 0.001). Disagreement regarding character of the lesion was seen only in a few number of cases. Gross per-operative findings and histopathology reports showed 100% concordance with the investigative results.</p> Conclusion <p>150 subjects with adnexal masses were evaluated. No statistically significant difference was found between CEUS and MRI findings with regard to size, character, location, intra-operative appearance and histopathological results of the lesions. Thus we can conclude that CEUS can be considered an effective alternative to MRI for the evaluation of adnexal lesions.</p>