Introduction: Ovarian-containing inguinal hernia is an uncommon but clinically significant condition in female neonates, arising from persistence of the canal of Nuck. Compared with bowel-containing hernias, ovarian herniation carries a markedly higher risk of incarceration, torsion, and vascular compromise because of the ovary’s relative bulk and restricted mobility within the inguinal canal. Delayed diagnosis or management may result in ovarian necrosis, with potential long-term consequences for endocrine function and future fertility . Early recognition and timely surgical intervention are therefore essential, even in asymptomatic infants. Case Report: A 20-day-old term female neonate presented with a firm, non-reducible mass in the left inguinal region, first noticed by the mother on day 18 of life. The infant was clinically stable, afebrile, feeding well, and showed no signs of pain, bowel obstruction, or systemic illness. Examination revealed a well-defined, non-tender inguinal swelling measuring approximately 1.5 × 1.5 cm, with a soft, non-distended abdomen and normal external genitalia. Ultrasonography demonstrated absence of the left ovary from the pelvis with herniation of the ovary into the left inguinal canal, confirming an ovarian-containing inguinal hernia. The patient was urgently referred to paediatric surgery for definitive management aimed at ovarian preservation. Discussion: This case highlights the importance of evaluation of inguinal masses in female neonates. Ovarian inguinal hernias should be considered surgical emergencies, as torsion and irreversible ischemic injury may occur even in clinically well infants. Prompt ultrasonographic assessment and early surgical referral are critical to optimize outcomes and preserve ovarian viability and overall outcomes.