〔Abstract〕 Objective To analyze the application of contrast-enhanced ultrasonography (CEUS) in the differentiation of benign and malignant ovarian tumors and the evaluation of ovarian tumor blood vessels. Methods A total of 86 patients with ovarian tumor admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to January 2022 were selected for preoperative CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Tumor specimens were resected and immunohistochemistry was performed after surgery. Vascular endothelial cells were labeled with CD34 monoclonal antibody and tumor microvascular density (MVD) was calculated. The correlation between CEUS and DCE-MRI parameters and MVD was analyzed. Results 80 cases were correctly diagnosed by CEUS imaging, 78 cases were correctly diagnosed by DCE-MRI imaging. The sensitivity, specificity and accuracy of CEUS imaging were 90.32%, 94.55%, 93.2%, positive and negative predictive values were 90.32%, 94.55%, respectively. The diagnostic sensitivity, specificity and accuracy of DCE-MRI were 87.10%, 92.73%, 90.70%, positive and negative predictive values were 87.10%, 92.73%, respectively. Peak intensity (PI), area under curve (AUC), volume ratio of extracellular space (Ve) and volume transfer constant (Ktrans) in malignant group were significantly higher than those in the benign group, the time to peak intensity (TTP) and arrival time (AT) were significantly lower than those in the benign group, the differences were statistically significant (P < 0.05). Pearson correlation analysis showed that PI, AUC, Ktrans, Ve were positively correlated with MVD, while TTP, AT were negatively correlated with MVD. ConclusionCEUS can effectively identify benign and malignant ovarian tumors and accurately evaluate the blood vessels of ovarian tumors.