Objective To investigate the value of intravoxel incoherent motion(IVIM) imaging combined with serum CA125 in the qualitative diagnosis of ovarian occupying lesions. Methods Retrospectively analyzed the IVIM images and serum CA125 of 31 patients with benign ovarian tumors and 30 patients withmalignant ovarian tumors, compared the differences of the parameters in monoexponential, biexponential and stretched-exponential models and serum CA125 level between the two groups,evaluated the thresholds and diagnostic efficiency of the parameters by the receiver operating characteristic (ROC) curve,and analyzed the correlation between the parameters and serum CA125. Results The ADC-stand, ADC-slow, DDC and α values in benign ovarian tumors were higher than those in malignant ovarian tumors, and the area under the ROC curve was 0.988, 0.985, 0.946, 0.742. The diagnostic thresholds were 1.230×10-3mm2 /s, 0.913×10-3mm2 /s, 1.230×10-3mm2 /s, 0.742, respectively. The ADC-stand, ADC-slow and DDC values in malignant tumor group was negatively correlated with the level of serum CA125(r=-0.773, -0.519, -0.507, P均＜0.05). The sensitivity of MR+IVIM+CA125 in the differential diagnosis of benign and malignant ovarian tumors was 93.33%, the specificity was 93.54%, the accuracy was 93.44%, Youden index was 86.87%. Conclusion The combination of multi-model IVIM parameters and serum CA125 level can provide a reliable reference marker for qualitative diagnosis of ovarian tumors.