Tubo-ovarian abscess (TOA) is one of the many complications of pelvic inflammatory disease (PID). It is uncommon in woman who are sexually inactive. Adolescent pelvic inflammatory disease although rare can present with serious and lifelong consequences. Right diagnosis and timely interventions are required in young women to prevent its complications, like infertility, chronic pelvic pain, frozen pelvis, and ectopic pregnancy. When dealing with virgin PID, it is important to keep in mind the other routes of spread of infection and the uncommon organisms that may be the cause. Minimally invasive surgery which minimizes postoperative complications and enhances recovery is one of the best options for the management of tubo-ovarian abscesses not responding to medical management.
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