Krukenberg tumours are very rare metastatic malignancies of the ovary that commonly arise from a gastrointestinal primary, with an incidence of 0.16 per 100 000.1 This case study explores the radiological and intraoperative images of a 48-year-old female with a large multiloculated pelvic mass, secondary to a newly diagnosed rectal cancer. The clinical features, unique images and histopathology of this case are presented to demonstrate the importance of early diagnosis and a multidisciplinary approach with synchronous colorectal and gynaecological resection of Krukenburg tumours.