Tubo-ovarian abscesses (TOA) are known and severe complications of acute pelvic inflammatory diseases (PID). In our experience, in a past series of 80, TOA treated conservatively, 72 patients (90%) experienced a quick and complete recovery. Only eight patients had a second surgical procedure: Five elder patients had hysterectomy and bilateral adnexectomy and three younger patients had unilateral adnexectomy. A similar satisfactory recovery was reported by others. Laparoscopic treatment associated with antibiotics is recommended when TOA is diagnosed or suspected. Two points to focus on in common TOA are differences between recent abscesses and those of long duration and excellent functional prognosis of the former due to laparoscopic treatment. Conservative surgery results in quick recovery with a very low risk of complication. Primitive intraovarian abscesses may be treated by laparoscopic or ultrasound guided conservative drainage associated with medical treatment, or ovariectomy, depending on patient age and fertility.