Abstract: Objective To estimate the clinical value of diagnosing early ovarian cancer by using transvaginal color doppler sonography(TVCDS), combined with the levels of serum tumor markers HE4 and CA125.Methods A total of 151 patients with adnexal masses admitted for elective surgery were selected. According to the postoperative pathologic results, they were divided into ovarian cancer group (group A, 48 cases) and ovarian benign lesions group (group B, 103 cases). All patients were examined by TVCDS and the determination of serum HE4 and CA125 level before surgery. The results were compared with pathological diagnosis after surgery.Results Serum HE4 and CA125 levels of the patients in group A were higher than those in group B. TVCDS parameters S/D, PI and RI were significantly lower in group A than in group B. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of TVCDS and HE4+CA125 in ovarian cancer diagnosis were 94.70%, 93.75%, 95.15%, 90.00%, 97.03%, respectively. The values were higher than the value of the separate checks.Conclusion TVCDS combined determination of serum HE4 and CA125 level is helpful to the improvement of clinical diagnosis in ovarian cancer.