Advances in prenatal ultrasound (US) have increased the number of congenital anomalies detected in utero. We present a case of an ovarian cyst identified at 22 weeks gestation. Further imaging obtained postnatally demonstrated a 5.8cm complex cyst in the right abdomen. Abdominal exploration at 2 months of age revealed a completely necrotic right ovary which was resected. Histologic findings confirmed extensive necrosis with no viable ovarian stroma remaining. This case provides an opportunity to highlight the diagnostic criteria and clinical management of in utero ovarian torsion.