Background: Ovarian tumours exhibit diverse imaging characteristics, and differentiating benign from malignant lesions is essential for appropriate management. Ultrasonography (USG) provides initial morphological assessment, whereas contrast-enhanced computed tomography (CECT) helps evaluate tumour extent and extra-ovarian spread. Aim: To compare USG and CECT in characterising ovarian tumours, identifying imaging features associated with malignancy, and assessing disease extent. Methods: This cross-sectional study included 73 patients with ovarian tumours evaluated at a tertiary care hospital. All patients underwent USG, including colour Doppler assessment, and CECT. Clinical characteristics, serum CA-125 levels, imaging findings, histopathological diagnoses, and FIGO stage were analysed. Imaging findings were compared between benign and malignant tumours, and agreement between USG and CECT was assessed for selected parameters. Results: Of the 73 patients, 48 (65.8%) had malignant tumours, 18 (24.7%) had benign tumours, and seven (9.6%) had borderline tumours. Malignant cases had a mean age of 52.5 ± 11.8 years, and 68.8% were postmenopausal. On USG, solid components, irregular walls, papillary projections, and ascites were observed in 100%, 89.6%, 68.8%, and 85.4% of malignant cases, respectively. High Doppler vascularity scores (3–4) were present in 93.8%. CECT demonstrated heterogeneous or intensely heterogeneous enhancement in 91.7% and necrosis in 58.3%. Omental involvement, peritoneal deposits, and lymphadenopathy occurred in 68.8%, 56.2%, and 54.2%, respectively. Advanced-stage disease (FIGO III–IV) accounted for 60.4% of malignant cases. USG and CECT showed strong correlation for tumour size (r = 0.988). Conclusion: USG and CECT provide complementary information for ovarian tumour characterisation and assessment of disease extent. Their combined use may support preoperative evaluation and treatment planning, with histopathology remaining essential for defini