Abstract: A case-control study to identify the risk factors for ovarian carcinoma in Tiruchirapalli district, Tamilnadu, India a low incidence population was conducted. The invasive epithelial ovarian cancer case patients were 37. The control group consisted of 74 healthy women, matched according to age categories. Subjects were interviewed in person regarding socio demographic and reproductive characteristics. The unconditional logistic regression was performed and tests of statistical significance were based on difference in the log likelihoods and all p values were 2-sided. In logistic regression analysis, the risk of ovarian cancer was strongly related to the increased physical activity (OR: 3.227, 95% CI: 1.143, 9.108), intake of high fat (OR: 6.286, 95% CI: 0.779, 50.701) early age at menarche (OR: 6.389, 95% CI: 2.143, 19.047), post menopausal status (OR: 3.22, 95% CI: 1.417, 7.316). The use of contraceptive methods, tubal ligation, one birth, late menarche was found to be inversely associated with ovarian cancer risk. The risk of ovarian cancer decreased 80% by one birth event, 40% by use of contraceptives and tubal ligation and six times reduced risk for menarche at later age. The present study thus clearly typified this neoplasm as hormone dependent and it is possible to establish that "ovulation" mechanism determine the level of risk for ovarian cancer in this study population. In addition, the difference in the distribution of histologic subtypes in this population compared with high-incidence populations may point to further differences in risk factors.