The evaluation of pelvic masses is routinely performed by transabdominal ultrasound. However, by placing the transducer into the vagina (the endovaginal approach), imaging resolution is improved and morphologic detail of true pelvic organs is increased. Twenty-one cases in which nonobstetrical pelvic pathology was suspected clinically were evaluated by both the endovaginal and (conventional) transabdominal approach. Each case was evaluated for efficacy of the two approaches independently and the results compared to the clinical outcome. Endovaginal scanning offered more accurate diagnostic information in 13 of the 21 cases (62%). Additional information was obtained by the endovaginal approach in seven of these 13 cases (55%). No significant difference was observed in 33%. Endovaginal ultrasound offers a diagnostic tool complementary to the transabdominal technique in the evaluation of pelvic masses in the female patient.