What does multiple bilateral ovarian follicles mean on abdominal ultrasound?

Normal finding: Ovarian follicles are where eggs develop. During a normal cycle, many eggs start to develop in these follicles until one of them (or sometimes more, in the case of twins/triplets) pops out. "popping out" is ovulation. When many follicles are seen on ultrasound, it just means they were able to see lots of them developing prior to ovulation.

Ovarian follicles: Ovarian follicles/follicular cysts are a common and typically benign finding during pelvic ultrasound. Usually they are bilateral, multiple, of varying sizes and are of no consequence. When the follicles are arranged peripherally (around the outside border of the ovary) this may reflect the presence of polycystic ovaries (which may require additional bloodwork/hormonal evaluation).