Mature ovarian teratomas are a benign subset of germ cell tumors (GCT) often diagnosed during reproductive years and are the most common GCT among children and adolescents. Many are found incidentally on unrelated imaging. There are no definitive guidelines on the management of these teratomas, particularly in the pediatric population. This case presents the management of an adolescent patient with an incidentally found ovarian teratoma. A discussion of contemporary literature also identifies a significant gap in the literature for definitive guidelines in pediatric patients with mature teratomas.