The role of minimally invasive surgery (MIS) for ovarian neoplasms in paediatric patients depends on multiple factors. First, it is important to consider the risk of malignancy, which can be difficult to assess, especially in the setting of torsion. Second, when possible ovarian sparing surgery (OSS) should be performed. In certain settings MIS to perform OSS may carry a higher risk of tumour or cyst spillage. MIS can also play a role in diagnosis, via staging or biopsy. When performed, MIS can offer improved visualization of the contralateral ovary and other abdominal structures. Overall, MIS for ovarian neoplasms offers improved visualization of pelvic structures and decreased risk of adhesions in addition to the traditional benefits of MIS. However, these advantages should not supersede the need to achieve complete oncologic resection and to minimize the risk of capsule rupture.