Tubo-ovarian abscess as a complication of acute salpingitis or salpingo-oophoritis is very uncommon in pre-menarchal and/or sexually inactive girls. It is generally the result of a blood-borne or genitourinary infection. Early diagnosis and treatment are essential to prevent future sequelae causing infertility. Laparoscopic surgery which minimises postoperative complications should be the first option in the treatment of TOA.