Metastatic ovarian tumors, representing 5–28% of ovarian malignancies, present significant diagnostic challenges due to their diverse origins and nonspecific clinical manifestations. These tumors frequently originate from the gastrointestinal tract, breast, and other non-gynecologic cancers, necessitating differentiation from primary ovarian neoplasms to provide effective treatment and management. This paper reviews the pathogenesis, diagnostic approaches, and management strategies for metastatic ovarian tumors. The paper presents the case report of a 72-year-old woman with a history of hypertension, coronary disease, obesity and bilateral solid adnexal masses found on routine transvaginal ultrasound. Although tumor markers such as CA-125 and HE4 were within normal limits, CA-19-9 was markedly elevated. Subsequent magnetic resonance imaging and computed tomography scan as well as biopsies revealed disseminated colorectal cancer with metastases to the ovaries and bones. Due to the advanced stage of the disease, the patient was referred to palliative care. It is concluded that bilateral solid adnexal masses in postmenopausal women should raise suspicion of metastatic disease, with accurate diagnosis relying on imaging, tumor markers, and histopathology. Individualized management plans, including surgery and chemotherapy, are essential. Despite the potential for improved survival with optimal cytoreduction, the prognosis for metastatic ovarian tumors remains poor, highlighting the importance of early and precise diagnosis.