What's supposed to hurt if i have an ovarian cyst?

Depends: If an ovarian cyst gets large enough or puts enough pressure on structures then pt may present with lower abdominal pain on the side of the cyst. If the cyst is large enough to cause torsion (twisting of the blood vessels feeding the ovary) that may lead to more severe pain and vomiting. Torsion is a surgical emergency because it may lead to the death of the ovary.