Ovarian malignancy is a disease of the postmenopausal women. Almost 75% of the patients present in an advanced stage as abdominal disease. Early disease detection is difficult as there are no specific symptoms and no specific screening tests with good sensitivity and specificity. Over the years transvaginal ultrasound and serum levels of CA 125 has emerged as effective tools for screening high risk population, like postmenopausal women and BRCA1 or BRCA2 carriers. TVS (transvaginal sonography) helps in assessing the volume of the ovaries. A cut off ovarian volume of 8 cm3 in postmenopausal woman and 18 cm3 in premenopausal woman needs further evaluation. Different morphological features like large tumor (more than 10 cms), solid or complex lesion, thick septae, papillary excrescences, and pouch of Douglas fluid, all are features suggestive of malignancy. Study of Doppler flow of the mass helps to reduce false positive rate in diagnosing malignancy. Malignant tumors contain dialated, saccular and randomly dispersed vessels. Centrally located flow, flow along septations, and flow within capillary excrescences also suggest malignancy. Low resistance index of <1 is more in favour of neovascularisation; CA 125 of > 30iu/ml in menopausal women and > 200iu/ml in reproductive age group is considered abnormal. Recent research shows that the use of proteomics may help early detection of these tumors before they become clinically manifest. This involves measurement of specific proteins in the blood using mass spectrometry. This technique is said to detect patients going to develop the malignancy many years earlier.