A tubo-ovarian abscess (TOA) is a complex infectious mass of the adnexa that forms as a sequela of pelvic inflammatory disease. Classically, a TOA manifests with an adnexal mass, fever, elevated white blood cell count, lower abdominal-pelvic pain, and/or vaginal discharge; however, presentations of this disease can be highly variable. Should the abscess rupture, life-threatening sepsis can result, thus any clinical concern for this diagnosis requires prompt evaluation and treatment. Tubo-ovarian abscesses are one of the late complications of pelvic inflammatory disease (PID) and can be life-threatening if the abscess ruptures and results in sepsis. It consists of an encapsulated or confined 'pocket of pus' with defined boundaries that forms during an infection of a fallopian tube and ovary.