Ovarian fibromas are benign tumors arising from the stromal component of the ovary. They mostly are asymptomatic. These tumors are often detected as incidental finding detected on routine gynaecological examination, transvaginal ultrasound, computer tomography or magnetic resonance imaging. We report a case of twisted ovarian fibroma with raised HCG levels and ascites mimicking ruptured ectopic pregnancy in young nulliparous married female.