Objective: To evaluate the general characteristics and outcomes of adolescent girls who underwent ovarian cystectomy at our center over a one-year period, emphasizing the importance of conservative surgical approaches and ovarian preservation in this demographic. Materials and Methods: This retrospective study included 15 adolescent girls who underwent ovarian cyst surgery at our clinic from March 2023 to March 2024. We collected data on age at menarche, menstrual patterns, family history, and preoperative measurements such as height, weight, and various tumor and hormonal markers. Imaging studies before surgery were reviewed. Results: The median age of the patients was approximately 14.8 years. Most patients presented with abdominal pain, and imaging showed a mix of simple and complex cystic structures. Pathology results revealed a predominance of simple cysts, with a few cases of paratubal serous cysts, endometriomas, serous cyst adenomas, and one juvenile granulosa cell tumor. Surgical treatment was generally indicated by large cyst size, symptoms of torsion, or suspicion of malignancy. Conclusions: Our findings highlight the varied presentations and surgical needs of adolescent girls with ovarian cysts. Emphasizing conservative surgical strategies that prioritize ovarian preservation is crucial in this age group due to the low malignancy rates and significant potential for future reproductive health implications. The outcomes underscore the necessity for careful preoperative evaluation and tailored surgical approaches based on individual patient characteristics and cyst features.