Ovarian cancer is one of the three most important cancers in women. Roma Index is a calculated value and uses two tumour markers HE4 (human epididymis protein) hormone and CA125 along with their menopausal status to predict ovarian cancer. By measuring both markers together the strength of both markers can be combined for optimized sensitivity and specificity for primary diagnosis. So it is a more strong predictor of malignancy than either alone in patients presenting with an adnexal mass. Roma index is indicated for women over 18 years of age and present with an adnexal mass. It classifies patients as low or high risk for ovarian malignancy. However it has to be correlated with clinical and radiological findings and it consists of the following tests-ca-125, + he4.