Ovarian masses in pediatric female patients, while uncommon, represent a significant clinical concern due to their varied etiology, ranging from benign functional cysts to rare malignant tumors. This chapter explores the epidemiology, pathology, diagnosis, and surgical management of ovarian masses in children and adolescents, with a particular focus on ovarian-sparing strategies and the growing role of robotic-assisted surgery. Germ cell tumors, particularly mature cystic teratomas, account for most neoplasms in this age group and are typically benign. Epithelial tumors, although less common in children, also form part of the differential diagnosis and require careful evaluation. Complications such as adnexal torsion are relatively frequent and typically involve benign lesions. Timely diagnosis relies heavily on ultrasound and MRI, while tumor markers aid in the assessment of malignancy risk. The surgical approach aims to preserve ovarian function and minimize invasiveness, making robotic surgery an increasingly valuable tool in elective cases. With technological advancements—such as smaller instruments, improved 3D visualization, and refined surgical techniques—robotic surgery enables precise dissection and tissue preservation, even in smaller pediatric patients. Detailed protocols for patient positioning, port placement, and intraoperative strategies are outlined, emphasizing the importance of minimizing ovarian damage, preventing abdominal contamination, and ensuring effective extraction of the mass. The chapter also provides practical tips and tricks for safe and effective robotic-assisted ovarian-sparing surgery, supported by the latest insights in training and postoperative care. Ultimately, a patient-centered, fertility-preserving, and minimally invasive approach is advocated, offering favorable outcomes for young patients with ovarian masses.