OBJECTIVE: The goal of this study was to assess the feasibility, safety, and cost effectiveness of minilaparotomy for the outpatient surgical management of ovarian cysts. STUDY DESIGN: Twenty-four consecutive patients 50 years old with 28 complex or persistent ovarian cysts 10 cm in maximum size underwent cystectomy or oophorectomy by minilaparotomy. Bupivacaine hydrochloride was injected in the wounds and ketoralac tromethamine (Toradol) administered systemically. The ovaries were reconstructed. RESULTS: All 24 patients were discharged on the day of surgery. There were no readmissions. Mean operative time was 45 min. The only complication was a single case of urinary retention managed on an outpatient basis. CONCLUSION: Minilaparotomy is a safe, cost-effective alternative to laparoscopy for the outpatient surgical management of ovarian cysts.