Background: Large benign ovarian tumors in post-menopausal women present a unique clinical challenge due to the potential for significant morbidity and the differential diagnosis with malignant tumors. Understanding their clinical presentation, management, and outcomes is crucial for optimizing patient care. Methods: This retrospective study analyzed 150 post-menopausal women who underwent surgical management for large benign ovarian tumors at a tertiary care hospital over five years. Data on demographic characteristics, clinical presentation, diagnostic methods, surgical management, and outcomes were collected and analyzed. Results: The majority of tumors were serous cystadenomas (40%), followed by mucinous cystadenomas (35%), benign cystic teratomas (20%), and fibromas (5%). Ultrasound was the primary diagnostic tool, supplemented by MRI in 50% of cases. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was the most common surgical procedure (70%). The average hospital stay was 5 days, with postoperative complications being rare. No recurrences or malignancies were observed during the median follow-up of 36 months. Conclusion: Large benign ovarian tumors in post-menopausal women can be effectively managed with surgery, leading to favorable outcomes. The low rate of complications and absence of malignancy on follow-up highlights the effectiveness of current diagnostic and management strategies. Recommendation: Clinicians should maintain a high index of suspicion for large benign ovarian tumors in post-menopausal women presenting with abdominal distension or discovered incidentally. Early and accurate diagnosis, followed by appropriate surgical management, is recommended to ensure optimal outcomes.