Yagur Y, et al. - In this study, management and outcome of tubo-ovarian abscess (TOA) in pre- and postmenopausal women in a tertiary referral center were delineated. In addition, the optimal approach for TOA in postmenopausal women is reassessed. The study cohort comprised 144 (69.23%) women [105 (72.92%) premenopausal and 39 (27.08%) postmenopausal]. As per univariate analysis, the two groups had no differences in risk factors and disease characteristics. Among the study sample, surgical treatment was undertaken in 22 (56.4%) postmenopausal women and 48 (45.7%) premenopausal women. The postmenopausal women with TOA had the concurrent pelvic malignancy prevalence of 2.6%, which is higher when compared to the general population, but is lower than that reported in the literature. Conservative management was undertaken in 44% without any apparent cases of misdiagnoses of cancer.