Ovarian cancer is the 3rd leading site of cancer among women in India. Screening of ovarian cancer pose a challenge to clinicians which is when RMI was standardized to improve pre-operative evaluation. RMI-4 is a simple scoring method based on menopausal status, USG findings, serum CA-125 levels and size of the tumor. The objective of the study is to analyze the effectiveness of RMI-4 with a cut off value of 200 in diagnostic evaluation and histopathological correlation. Method: Women with ovarian neoplasm, who underwent exploratory laparotomy in Yenepoya University from August 2016-May 2017, are included. RMI-4 calculated. Results: 86 patients were included in the study, 65 were reported as benign, 7 as borderline and 14 as malignant ovarian mass. RMI-4 with a cut off value of 200 and above with histopathological analysis is more accurate in predicting malignant rather than benign ovarian neoplasm with a sensitivity of 76.9%, specificity of 93.8%, PPV of 71.4%, NPV of 95.3%, and a diagnostic accuracy of 91%. Conclusion: RMI-4 is a valuable, simple, easily applicable and reliable method in primary evaluation of patients with malignant ovarian masses.