Ovarian cancer has often been described as a “silent killer,” but recent studies have shown that there are symptoms that appear in the early stages of the disease. Recognition of these symptoms is critical because early diagnosis improves the probability of cure. Use of serum biomarkers for the diagnosis of epithelial ovarian cancer is an active area of investigation. Biomarkers or panels of biomarkers are generally used in combination with each other or with other findings (eg, ultrasound). Only a few biomarkers are commercially available. Cancer antigen 125 (CA-125) has been the focus of most investigations and is used most extensively. Other diagnostic tests for epithelial ovarian cancer include human epididymis protein (HE4), the OVA1 panel (overian canser test1), and the Risk of Malignancy Algorithm (ROMA).