The relatively low survival rate in patients with advanced-stage carcinoma ovaries requires early detection to improve treatment outcomes. The method currently used to determine the administration of neoadjuvant chemotherapy is ascites cytology and laparoscopic. This study aims to find a non-invasive technique in determining preoperative Neoadjuvant Chemotherapy administration, and that method can use as a predictor of advanced epithelial ovarian carcinoma. The benefit of this study is to help clinicians consider administering neoadjuvant chemotherapy with a Risk Of Malignancy Index 4 score. An analytical observational study with a retrospective cross-sectional type study with samples of all patients from January 2016 to January 2020 diagnosed at the dr. Saiful Anwar Hospital in Malang indonesia. The number of initial samples of this study is 106 samples. Between the results of the Risk Of Malignancy Index 4 score and the histopathological results, it finds that the p-value was less than 0.05 (p<0.05) indicates that the Risk Of Malignancy Index 4 score is very good for predicting advanced epithelial ovarian carcinoma. With a sensitivity of 86,2%, specificity of 87,5%, the cut of value Risk Of Malignancy Index 4 to be a predictor of advanced ovarian carcinoma is 2982. This study indicates that the Risk Of Malignancy Index 4 score is excellent for predicting the stage of Epithelial Ovarian Carcinoma. This cut-off value can reference preoperative neoadjuvant therapy to avoid morbidity and mortality due to the high risk of surgery.