Abstract: Objective To evaluate the role of ROMA in the diagnosis of malignant ovarian cancer. Methods 128 cases of malignant ovarian cancer patient were enrolled in this study, 86 cases of benign ovarian tumor patient and 78 cases of healthy individuals served as the control. Electro-chemiluminescence immunoassay was used to determine the expression of HE4 and CA125. Results The positive predictive values of ROMA in pre-menopausal and postmenopausal women were 34.13%, 89.93%, respectively. The sensitive rate in the two groups was 75.57%, 90.36%, respectively. The specific rate in the two groups was 75.36%, 84.11%, respectively. Conclusion ROMA could be obtained by detecting the expression of HE4 and CA125. It has a highly specific rate in the diagnosis of malignant ovarian cancer, especially for pre-menopausal and post-menopausal women.