Poor echogenicity within an ovarian cyst is usually benign, but it can also be malignant and further tests are needed to determine this. Ovarian cysts can be caused by chocolate cysts, which can lead to the development of poor echogenicity in ovarian cysts. In most cases, poor echo within an ovarian cyst is not malignant. Poor intracystic echogenicity is mainly anechoic areas formed by fluid accumulation in the thoracic and abdominal cavities. An ovarian cyst is a sac-like structure that forms within a woman’s ovary and is filled with fluid. Ovarian cysts are usually not harmful and are benign cysts. If the poor echogenicity is caused by a chocolate cyst, it usually does not cause any symptoms, and if the cyst is small in size it does not need to undergo special treatment, and it needs to be reviewed regularly. Therefore, in the clinic, when patients suffer from ovarian cysts, it is recommended to go to the hospital for regular review and treatment under the guidance of the doctor.