The widespread use of ultrasonography in pregnancy has led to an increase in the detection of ovarian cysts in pregnant women. The majority of these are benign and only require surgical management if they are associated with pain, torsion or an increase in size. The optimal approach to surgical management is via laparoscopic excision, as opposed to laparotomy, which is associated with increased hospital stay, blood loss and post-operative pain1. Herein, we discuss a case of second trimester laparoscopic cystectomy of a 10cm benign ovarian cyst. We illustrate, with the aid of video demonstration, techniques of approach to laparoscopic cystectomy during pregnancy in order to recognise anatomical variations, minimise iatrogenic cysts spill and trauma to the uterus, reducing both maternal and fetal risk. With increased surgical caseload and innovative minimally invasive surgical technique for cystectomy, we anticipate this will become the gold standard approach.