Context: retained surgical items (RSI) are a preventable cause of patient morbidity and sometimes mortality. Commonest RSI being sponge. Because of delay from surgery to presentation and varied symptoms patients are often misdiagnosed preoperatively. Objective: present clinical presentation and management of a case of gossypiboma . Method Patient : a para 1, presented with gradually increasing abdominal distension for 5 months. There was no history of fever, weight loss or loss of appetite. She had delivered by cesarean section 1 year back. On examination a cystic mass was filling the whole abdomen. She was carrying an MRI and USG films reported as possibly dermoid cyst. Intervention: laparotomy, Main outcome measures: drainage of 5 litres of pus and removal of sponge from pseudocyst in abdominal cavity. Results : uneventful postoperative period. Conclusion: accurate sponge count and better communication between members of surgical team is mandatory to avoid such complication. The diagnosis of RSI should be kept in mind in any postoperative patient who presents with pain, fever or palpable mass.