Objective: This study proposed to evaluate if Risk of Malignancy Index (RMI) is able to select relevant patients for referral in our clientele and aims at establishing a cutoff level of RMI best representing our population to distinguish which patient should be referred for primary centralized surgery at tertiary care centre with expertise of gynaecologic oncologist. Methods: 100 patients with adenexal mass/masses were analyzed with RMI. The RMI is calculated as the product of the ultrasound score (U), the menopausal score (M), and the absolute value of serum CA 125.