72 women aged from 24 up to 76 years old with unilateral and bilateral ovarian lesions (with size more than 30 mm) were examined. B-mode and Doppler ultrasound data was assessed according to the score system. Cut-off value for ovarian cancer diagnosis was equal to score 8. CA125, HE4, and ROMA (Risk of Ovarian Malignancy Algorithm) were assessed before the surgery. Malignant lesions were revealed in 23 (33.3%) patients, benign - in 48 (66.4%). The only ultrasound value was higher (sensitivity - 89%, specificity - 89%, accuracy - 89%) then other diagnostic modalities in postmenopausal patients. Ultrasound was sufficient for malignant lesion diagnosis in postmenopausal period. Ultrasound and ROMA at the first step and only HE4 assessment at the second step were recommended in premenopausal patients. It increased sensitivity and specificity up to 100% in our study. Positive result of ultrasound was sufficient for malignant lesions diagnosis without considering the ROMA results. HE4 tumor marker was assessed at second step if ultrasound result was negative and ROMA result positive. Positive result of HE4 was used as the marker of malignant lesion. Lesion was considered as a benign in cases of negative HE4. Malignant lesions were excluded if ultrasound and ROMA results were negative. This algorithm should be studied more precisely. More data is needed.