Objective To retrospectively analyze the multi-slice spiral CT and magnetic resonance imaging (MRI) findings of patients with ovarian clear cell adenocarcinoma (OCCA). Methods The clinical data of 14 patients with pathologically confirmed OCCA were retrospectively analyzed. All patients underwent CT and MRI examination. The imaging findings were summarized. Results Fourteen cases of patients were with cystic mixed masses. Multi-slice spiral CT scan showed that the density of tumors was homogeneous, with clear boundaries, irregular mass-like solid components or papillary nodules in masses. Enhanced scan showed that cystic components were without obvious enhancement, and in arterial phase, the solid components were with presence of moderate enhancement and in venous phase with continuing enhancement. MRI examination showed low signal on cystic cavity T1WI in 10 cases and equal high signal in 4 cases; There was equal high signal on cystic cavity T2WI; The solid components showed equal low signal on T1WI, slightly high signal on T2WI and slightly high signal on DWI. Conclusion Multi-slice spiral CT and MRI findings of patients with OCCA have certain characteristics, but lack for obvious specificity. It is suggested that related laboratory examination be combined to improve the preoperative diagnostic accuracy and reduce the risk of misdiagnosis and missed diagnosis.