Abstract: Objective To study the value of ultrasound in the diagnosis of benign, malignant or borderline ovarian tumor and the preoperative staging of patients with malignant ovarian tumor, and to provide image evidence for clinical treatment. Methods The preoperative ultrasonic images (transabdominal and Transvaginal sonography) and pathologic data of 87 cases of pathological-confirmed benign ovarian tumor, 53 cases of borderline ovarian tumor and 99 cases of malignant ovarian tumor between 2012 and 2016 were reviewed retrospectively. The difference of ultrasonic and pathological results in benign and malignant ovarian tumor was analyzed by consistency Chi square and Kappa test. The correlation between ultrasonic imaging features and ovarian borderline or invasive tumor was analyzed by univariate and multivariate logistic, and the prediction model was established. Results The sensitivity and specificity of ultrasound for benign and malignant ovarian were 90.80% and 96.05%. The accuracy of ultrasound for the preoperative staging of patients with malignant ovarian tumor was 94.12%, 89.19%, 90.63% and 90.32% for stage Ⅰ, Ⅱ, Ⅲ and Ⅳ, respectively. The model of differentiating borderline and invasive ovarian tumor was developed based on the following variables (P<0.05):cancer antigen 125, the greatest diameter of the tumor, septa, and solid parts on ultrasound imaging. The sensitivity and specificity of the model were 81.6% and 73.5% for patients aged < 50 years, 95.2% and 80.8% for those aged ≥ 50 years, respectively. Conclusion Ultrasound is helpful to the diagnosis of benign and malignant ovarian tumors, preoperative staging of patients with malignant tumor and prediction of borderline ovarian tumors, it is also important for the clinical treatment and prognosis assessment.