The purpose of this study is to illustrate the sonographic features of primary malignant tumors of the fallopian tube and to heighten awareness of their existence. This is a retrospective review of the imaging and clinical files of 7 patients with a primary malignant tumor of the fallopian tube found in the medical records of 4500 patients with primary gynecologic malignancies seen during the last 6 years at the authors’ institution. All patients had transvaginal sonography before surgery. Images were reviewed to determine common features of this rarely encountered pathology. Transvaginal sonography showed normal ovaries in 5 patients in association with a discrete solid adnexal mass in 4. The fallopian tube origin of the mass was shown directly in 2 of these 4 patients and was inferred in the other 2 on the basis of a mass in the expected location of the fallopian tube. In the 3 patients without a discrete adnexal mass, there were more extensive changes, including large, solid adnexal masses of unknown origin (n = 2) and gross peritoneal carcinomatosis (n = 1). Fallopian tube malignancies should be considered when unexplained solid masses corresponding with the expected location of the fallopian tubes are seen in association with normal ovaries. Disease dissemination may show carcinomatosis or more extensive pelvic disease.